Tolerability is the ceiling, and the ceiling is personal
Trial discontinuation figures are a floor, not an estimate: trial populations are supported in ways ordinary patients are not.
Salomé Adeyemi
Page 7 of 13 of this archive, newest first.
Archive — page 7
243 piecesDo you need the top of the ladder?
What the trials measured was continuation against withdrawal. What patients want to know is continuation at a lower dose, and that study has largely not been done.
The trade has decided the ceiling is arbitrary. The trials disagree.
Higher doses of these molecules have been studied. In general they produced modest additional efficacy and disproportionate additional symptom burden, which is why the…
What the new the United Kingdom guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
Maximum tolerated is not maximum approved
A plateau at an intermediate dose and a plateau at the maximum dose look identical from the outside and mean different things.
What the new Germany guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
The steps get smaller as the ladder gets higher, and that is deliberate
What the published pharmacokinetics permit, what the labels state, and where the two diverge.
What the new Norway guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
What the new Brazil guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
When to stop escalating and when to stop entirely
An effect is dose-limiting when it prevents adequate intake, prevents normal activity, or produces a risk of its own. Discomfort alone is not the test.
What the new France guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
What the new the Netherlands guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
What the trials counted as intolerance
We set out the questions that distinguish a symptom to manage from a dose to change.
What the new Spain guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
What the new Nigeria guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
What the new Denmark guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
Dual, triple, co-formulated: a taxonomy the coverage keeps collapsing
The glucagon arm raises energy expenditure and also raises hepatic glucose output. Balancing those is the whole engineering problem.
Non-responders, and the honest state of the evidence about them
The mechanism is well described. The variance is not.
Gallstones during rapid weight loss: drug, or weight loss?
We give background rates alongside trial rates, because an event occurring during treatment is not thereby caused by it.
What the new Portugal guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.