Maintenance dosing: what is licensed, what is practised, and what is evidenced
What the labels permit, what clinicians do, and the size of the gap between them.
Recent work
116 piecesSTEP 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.
SURPASS-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.
FLOW 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.
Reading the exenatide composition data without the press release
A substudy powered to describe a mean is not a substudy powered to detect a clinically meaningful individual change.
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.
The lowest effective dose is a real concept with almost no data behind it
A survey of the maintenance evidence, which is shorter than the survey of the withdrawal evidence.
STEP 5 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.
LEADER 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.
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.
What the trials monitored, and what that implies about routine practice
What the pivotal programmes measured and how often, which is a more defensible template than most published monitoring schedules.
STEP 5 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.
STEP 2 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.
Sarcopenia is a diagnosis, not a synonym for losing lean mass
The rule that a quarter of weight lost is lean tissue has been in textbooks for decades and does not survive close reading.
FLOW 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.
What the older diet-and-exercise trials found in the hip
The evidence base is one secondary analysis, several small studies and a large amount of extrapolation from bariatric surgery.
The glycaemic panel before treatment: what is worth measuring and when
The assay is not the problem. The interpretation of a lagging integral as a current measurement is the problem.
Two sessions a week, and the evidence behind the prescription
The recommendation survives scrutiny. The reasoning offered for it frequently does not.
The one randomised trial that combined an incretin with supervised exercise
Mass and function are different endpoints and training affects them differently. Most coverage treats them as one.
STEP 2 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.