Sarcopenia is a diagnosis, not a synonym for losing lean mass
The rule that a quarter of weight lost is lean tissue has been in textbooks for decades and does not survive close reading.
STEP programme
Page 15 of 18 of this archive, newest first.
SURPASS-2 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.
SELECT 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 placebo arms of the withdrawal trials actually tell us
Three randomised withdrawal designs have tested what happens when treatment stops. Their results are consistent and they are consistently misreported.
Why "muscle-sparing" is a marketing term and not a measurement
The gap between a defensible recommendation and a confident one is where most of the harm in this subject lives.
STEP 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.
What the protein literature actually shows, and in whom it was shown
Where the familiar figures come from, what populations they were measured in, and how far the extrapolation reaches.
What the placebo arms of the withdrawal trials actually tell us
Three randomised withdrawal designs have tested what happens when treatment stops. Their results are consistent and they are consistently misreported.
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.
What we would need to randomise to answer this properly
One randomised trial has combined a GLP-1 receptor agonist with supervised exercise. Its result is the single most useful piece of evidence in this area.
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.
SURMOUNT-OSA 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.
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.
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.
STEP 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.
The lowest effective dose is a real concept with almost no data behind it
Every withdrawal trial compared full dose against nothing. The clinically interesting comparison — full dose against a reduced one — has not been randomised.
TRIUMPH-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 STEP 4 tells us about maintenance, and what it does not
The commonest real-world strategy in this drug class is the least studied one.