diff --git a/entities/health/nct06548490-semaglutide-oud-phase2.md b/entities/health/nct06548490-semaglutide-oud-phase2.md
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+# NCT06548490: Semaglutide for OUD Phase 2 RCT
+
+**Type:** Clinical Trial Protocol
+**Status:** Active (ongoing, no results)
+**Phase:** 2
+**Design:** Randomized, double-blind, placebo-controlled
+**Registration:** NCT06548490
+**Principal Investigator:** Patricia S. Grigson, Penn State
+**Funding:** NIH
+**Publication:** Addiction Science & Clinical Practice, 2025
+
+## Trial Design
+
+**Population:**
+- 200 participants with treatment-refractory opioid use disorder
+- Already receiving standard MOUD (buprenorphine or methadone)
+- Outpatient setting
+- Three sites
+
+**Intervention:**
+- Semaglutide vs. placebo
+- 12-week treatment period
+- Added to existing MOUD background therapy
+
+**Primary Endpoint:**
+- Opioid abstinence (confirmed by urine drug screens + self-report)
+
+## Scientific Rationale
+
+**Preclinical Evidence:**
+- Rodent models show GLP-1 receptor agonists reduce opioid self-administration
+- Mechanism: GLP-1 receptors in ventral tegmental area modulate dopamine reward circuits
+
+**Clinical Evidence (pre-trial):**
+- Residential OUD population studies show decreased craving measures
+- Qeadan 2025 real-world data: 40% lower opioid overdose rate in GLP-1 RA users
+- No completed controlled trials in outpatient OUD as of protocol publication
+
+## Safety Considerations
+
+**Documented Concerns:**
+- Pancreatic cysts and cancer risk
+- Hypoglycemia
+- Muscle cramps
+- Cognitive slowing
+- Drug interactions with buprenorphine/methadone
+
+**Population Risk:**
+- Treatment-refractory patients represent high-difficulty population
+- Higher baseline risk for adverse outcomes
+
+## Significance
+
+**Why This Trial Matters:**
+- Only active well-powered Phase 2 RCT for GLP-1 in OUD
+- Tests whether real-world observational signal (Qeadan 2025) holds under controlled conditions
+- Specifically targets treatment-refractory population (not achieving abstinence with standard MOUD)
+- Will determine if GLP-1 reward circuit mechanism extends beyond food/alcohol to opioids
+
+**Expected Timeline:**
+- Results anticipated 2026-2027
+- Positive result would elevate GLP-1 OUD mechanism claim from "experimental" to "likely" confidence
+- Null result would suggest mechanism specificity to food/alcohol reward circuits
+
+## Timeline
+
+- **2025** — Protocol published in Addiction Science & Clinical Practice
+- **2025-2026** — Trial enrollment and treatment ongoing
+- **2026-2027** — Results expected (monitoring required)
+
+## Research Context
+
+Patricia Grigson is a leading addiction neuroscience researcher at Penn State College of Medicine. This NIH-funded trial represents the first rigorous controlled test of GLP-1 receptor agonists for opioid use disorder in an outpatient population already receiving medication-assisted treatment.
+
+## Monitoring Notes
+
+**Status:** Protocol-only publication. No results available as of April 2026.
+
+**Action Required:** Monitor for results publication Q3/Q4 2026 or early 2027. Results will directly inform whether the GLP-1 reward circuit mechanism claim can extend to opioids with "likely" confidence.
+
+**KB Impact:** When results publish, this becomes a primary source for evaluating the OUD extension of the existing claim "glp1-receptor-agonists-address-substance-use-disorders-through-mesolimbic-dopamine-modulation"
\ No newline at end of file
diff --git a/inbox/queue/2026-04-24-glp1-oud-rct-protocol-nct06548490-penn-state.md b/inbox/archive/health/2026-04-24-glp1-oud-rct-protocol-nct06548490-penn-state.md
similarity index 97%
rename from inbox/queue/2026-04-24-glp1-oud-rct-protocol-nct06548490-penn-state.md
rename to inbox/archive/health/2026-04-24-glp1-oud-rct-protocol-nct06548490-penn-state.md
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--- a/inbox/queue/2026-04-24-glp1-oud-rct-protocol-nct06548490-penn-state.md
+++ b/inbox/archive/health/2026-04-24-glp1-oud-rct-protocol-nct06548490-penn-state.md
@@ -7,9 +7,12 @@ date: 2025
 domain: health
 secondary_domains: []
 format: peer-reviewed study
-status: unprocessed
+status: processed
+processed_by: vida
+processed_date: 2026-04-24
 priority: medium
 tags: [glp-1, semaglutide, opioid-use-disorder, OUD, addiction, clinical-trial, Phase-2, VTA-dopamine, reward-circuit, NCT06548490]
+extraction_model: "anthropic/claude-sonnet-4.5"
 ---
 
 ## Content