Coming off: what the pharmacology permits
What a slow reduction could plausibly buy, and what it certainly cannot prevent.
Yuki Morishita
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142 piecesTRIUMPH-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.
Side effects, cost, supply, target: four reasons with four trajectories
Real-world persistence figures, with their definitions stated, because the definitions are doing most of the work.
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.
Maintenance dosing: what is licensed, what is practised, and what is evidenced
Every withdrawal trial compared full dose against nothing. The clinically interesting comparison — full dose against a reduced one — has not been randomised.
Adverse events by dose, adverse events by week
Almost every figure in circulation about tolerability comes from six publications. This is what they say.
SURPASS-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.
What actually helps, ranked by evidence
We separate what is supported, what is reasonable, and what is folklore, and we do not pretend the boundaries are crisp.
TRIUMPH-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.
What actually helps, ranked by evidence
Dietary measures are widely recommended, plausible on mechanism, and supported mainly by observational data and clinical experience.
SURMOUNT-1 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.
Fructosamine, glycated albumin, and the shorter window nobody orders
The alternatives with shorter windows, what they measure, and why they are rarely ordered.
Reading the semaglutide 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.
What a month without the drug does to tolerability
The convention — resume lower, re-escalate — is not caution. It follows directly from the elimination half-life.
Load, not cardio: the distinction the general advice keeps losing
Mass and function are different endpoints and training affects them differently. Most coverage treats them as one.
FLOW 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 the fifth week of a semaglutide dose feels different from the first
An accumulation model, drawn from published parameters, with its assumptions stated.
What has to change before a change has happened
A flag is a probability statement about a population. It is not a statement about the person holding the printout.
Load, not cardio: the distinction the general advice keeps losing
Mass and function are different endpoints and training affects them differently. Most coverage treats them as one.
Not everybody regains at the same rate, and nobody knows why
The variance around the mean regain trajectory is large and unexplained, exactly as it is for the weight loss.