What SURPASS-4 tells us about maintenance, and what it does not
Every withdrawal trial compared full dose against nothing. The clinically interesting comparison — full dose against a reduced one — has not been randomised.
Harriet Oduya
Page 7 of 10 of this archive, newest first.
Archive — page 7
192 piecesSTEP 3 extension data: what happens after the trial stops
A design note rather than a result: what the comparator was, and what that permits you to conclude.
Why the bone question is harder than the muscle question
A plausible mechanism, a measurable change, and no outcome data. This is what an open question looks like.
Medutest result on a Wuxi dulaglutide lot lands 2.0 points below the supplier’s figure
The supplier has not disputed the finding. It has not explained the gap either.
Thiamine and the vomiting patient
What the trials measured, which in the case of micronutrients is very little.
The one randomised trial that combined an incretin with supervised exercise
One randomised trial has combined a GLP-1 receptor agonist with supervised exercise. Its result is the single most useful piece of evidence in this area.
SURMOUNT-1 misses on a secondary endpoint the coverage has not mentioned
A design note rather than a result: what the comparator was, and what that permits you to conclude.
Why "muscle-sparing" is a marketing term and not a measurement
Almost every practical recommendation in circulation was established in a population that does not resemble the people now following it.
Maintenance dosing: what is licensed, what is practised, and what is evidenced
Dose reduction is not withdrawal, and the trials that tested withdrawal cannot be read as testing it.
Independent analysis puts a HJ tirzepatide lot at 97.3%, against 94.2% on the certificate
The supplier has not disputed the finding. It has not explained the gap either.
The hormonal adaptations persist for years. That is the mechanism.
The physiology of regain was described a decade before these drugs, and it explains the trajectory without invoking anything specific to them.
Janoshik result on a Xianning semaglutide lot lands 4.3 points below the supplier’s figure
The supplier has not disputed the finding. It has not explained the gap either.
PIONEER 6 extension data: what happens after the trial stops
A design note rather than a result: what the comparator was, and what that permits you to conclude.
STEP 4 misses on a secondary endpoint the coverage has not mentioned
A design note rather than a result: what the comparator was, and what that permits you to conclude.
VendorInvestigate result on a Nantong cagrilintide lot lands 4.4 points below the supplier’s figure
The report states the gradient, the wavelength and the integration threshold, which is more than most.
Independent analysis puts a SGN exenatide lot at 96.4%, against 94.7% on the certificate
The report states the gradient, the wavelength and the integration threshold, which is more than most.
What SURPASS-4 tells us about maintenance, and what it does not
A survey of the maintenance evidence, which is shorter than the survey of the withdrawal evidence.
SURMOUNT-4 misses on a secondary endpoint the coverage has not mentioned
A design note rather than a result: what the comparator was, and what that permits you to conclude.
Independent analysis puts a TFC dulaglutide lot at 95.8%, against 95.1% on the certificate
The report states the gradient, the wavelength and the integration threshold, which is more than most.
Independent analysis puts a FGP exenatide lot at 96.3%, against 92.6% on the certificate
The supplier has not disputed the finding. It has not explained the gap either.