A year after stopping: what the trials found at the far end
The physiology of regain was described a decade before these drugs, and it explains the trajectory without invoking anything specific to them.
Marguerite Vasseur
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Archive — page 8
182 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.
Pass, conform, comply: three words for three different claims
Statements of conformity are supposed to rest on a stated decision rule. Almost nothing in this trade states one.
Reading the dulaglutide titration schedule as a regulatory artefact
The published ladder exists because a protocol needed a single number. Practice has never followed it exactly, and the regulatory file never assumed it would.
SURMOUNT-3 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.
Bone density during rapid weight loss: what is known, which is less than you would hope
Density is a proxy for strength and an imperfect one, particularly when soft-tissue thickness over the measurement site is changing.
The mechanism behind the mechanism
What scintigraphy and breath-test studies established about emptying rate, and what they did not.
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.
Stepping down against stopping: two decisions treated as one
These agents produce no dependence and no withdrawal syndrome. What a taper would be for is therefore a real question rather than an obvious one.
A schedule that bends does not break
Reducing a dose is not going backwards. In a tolerability-limited class it is the mechanism by which the ceiling is found.
One receptor, several signals: the case for reading retatrutide as a biased agonist
What the in-vitro data supports, what it does not, and where the extrapolation to a person begins.
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.
Why "muscle-sparing" is a marketing term and not a measurement
The rule that a quarter of weight lost is lean tissue has been in textbooks for decades and does not survive close reading.
Side effects, cost, supply, target: four reasons with four trajectories
Why the reason for stopping changes what happens afterwards.
Gastric emptying is a mechanism, not a side effect
The central effects are not a bonus. On the current evidence they are the principal mechanism of weight loss.
PIONEER 6 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.
Gauge, pain and flow rate
Gauge affects pain and flow rate rather than depth. A finer needle is more comfortable and slower, and with a viscous solution the difference is noticeable.
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 3 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.
What the upper limit of normal for ALT should be, and why it is not
Asymptomatic pancreatic enzyme elevation is common on treatment and is not pancreatitis. The distinction is clinical, not biochemical.