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.
Clinical Trials in 2024
Page 3 of 11 of this archive, newest first.
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.
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.
Why the bone question is harder than the muscle question
Density is a proxy for strength and an imperfect one, particularly when soft-tissue thickness over the measurement site is changing.
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.
Bone density during rapid weight loss: what is known, which is less than you would hope
The evidence base is one secondary analysis, several small studies and a large amount of extrapolation from bariatric surgery.
STEP 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.
Weight regain is not a failure of willpower and it is not a mystery
The variance around the mean regain trajectory is large and unexplained, exactly as it is for the weight loss.
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.
SURPASS-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.
The withdrawal trials, read as designs rather than warnings
Three randomised withdrawal designs have tested what happens when treatment stops. Their results are consistent and they are consistently misreported.
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.
What we would need to randomise to answer this properly
The recommendation survives scrutiny. The reasoning offered for it frequently does not.
LEADER 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 placebo arms of the withdrawal trials actually tell us
What was withdrawn, from whom, after how long, and what was measured afterwards.
Why the bone question is harder than the muscle question
What the Journal would want measured before treating this as settled in either direction.
TRIUMPH-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.
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.
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 8 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.