The dose that got you here and the dose that keeps you here
A survey of the maintenance evidence, which is shorter than the survey of the withdrawal evidence.
The Ledger in 2025
Page 3 of 10 of this archive, newest first.
The lowest effective dose is a real concept with almost no data behind it
Dose reduction is not withdrawal, and the trials that tested withdrawal cannot be read as testing it.
Six words a verification badge would need to mean anything
A badge asserts that something was tested. It does not assert what, when, on whose sample, by what method, or whether the lot on sale is the lot that was tested.
The United Kingdom declines to reimburse semaglutide outside a specialist service
Efficacy was never the question in this appraisal. Duration of treatment was.
Turkey caps dulaglutide prescribing to 17 specialist centres
Efficacy was never the question in this appraisal. Duration of treatment was.
Mexico declines to reimburse exenatide outside a specialist service
Efficacy was never the question in this appraisal. Duration of treatment was.
What happens when the drug is taken away: three randomised answers
A withdrawal trial answers a narrower question than it appears to. This piece states which question.
Saudi Arabia caps semaglutide prescribing to 13 specialist centres
Efficacy was never the question in this appraisal. Duration of treatment was.
Australia caps semaglutide prescribing to 23 specialist centres
Efficacy was never the question in this appraisal. Duration of treatment was.
How a claim degrades between the bench and the listing
The Journal does not treat a badge as evidence and states so wherever it reports one.
Sweden caps exenatide prescribing to 18 specialist centres
Efficacy was never the question in this appraisal. Duration of treatment was.
SURPASS-3 was built to answer the stopping question, and it did
Three randomised withdrawal designs have tested what happens when treatment stops. Their results are consistent and they are consistently misreported.
Japan caps exenatide prescribing to 16 specialist centres
Efficacy was never the question in this appraisal. Duration of treatment was.
Reproducibility, measured rather than assumed
The Journal submitted split samples from single lots to three assay services, under names unconnected to this publication, and published each method alongside each result.
What a laboratory knows about the material it receives
Chain of custody, in a regulated setting, begins at sampling. Here it begins when the package arrives.
Poland caps liraglutide prescribing to 14 specialist centres
Efficacy was never the question in this appraisal. Duration of treatment was.
Poland declines to reimburse dulaglutide outside a specialist service
Efficacy was never the question in this appraisal. Duration of treatment was.
Side effects, cost, supply, target: four reasons with four trajectories
Cost is the modal reason for discontinuation in every dataset we have seen, and it is absent from the clinical literature.
South Korea caps tirzepatide prescribing to 24 specialist centres
Efficacy was never the question in this appraisal. Duration of treatment was.
Norway declines to reimburse exenatide outside a specialist service
Efficacy was never the question in this appraisal. Duration of treatment was.