SURMOUNT-4 was built to answer the stopping question, and it did
The regain trajectories, arm by arm, with the estimands named.
Volume III
Every issue published in 2026 to date — 6 numbers, 1,020 pieces.
Features in Volume 3
Same material, different gradients, different answers
Duplicate submissions under different names test within-laboratory repeatability, which is a different quantity from between-laboratory reproducibility.
What the trials counted as intolerance
We set out the questions that distinguish a symptom to manage from a dose to change.
What the anaesthetists said, and then said again
This is the single interaction with ordinary medical care that patients most need to disclose, and it is the one most often not asked about.
One method is one opinion
Aggregates dissociate in the mobile phase and are recorded as monomer. Only a size-based separation reports them.
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.
The eighteenth month, and the conversation that should have happened in the third
A plateau at an intermediate dose and a plateau at the maximum dose look identical from the outside and mean different things.
The instrument was calibrated on Tuesday. Your sample ran on Friday.
Calibration drift is real, unremarkable, and the reason serious laboratories run internal standards.
What the trials monitored, and what that implies about routine practice
The argument for a baseline panel is that it makes every subsequent result interpretable. The argument against frequent monitoring is that noise accumulates faster than…
Why the independent testing market grew a chemistry arm and not a microbiology one
Four independent services underpin confidence in this market. All four are competent at chemistry. Microbiology is a different accreditation, a different facility and a…
The mechanism behind the mechanism
The clinical effect profile is almost fully predictable from where the receptor is expressed, which is unusual and useful.
GIP was a failed target for thirty years. Then it was not.
What adding GIP activity does, on the current evidence, and what remains unresolved.
Peak capacity, and the honest measure of a separation
Gradient slope is the single most consequential method parameter for a reported purity figure, and it is the one most often omitted.
The skeleton responds to load, and load is falling
The evidence base is one secondary analysis, several small studies and a large amount of extrapolation from bariatric surgery.
The supply gap as a clinical event
Real-world persistence figures, with their definitions stated, because the definitions are doing most of the work.
Tolerability is the ceiling, and the ceiling is personal
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.
When a better instrument changes the answer rather than the confidence
Calibration drift is real, unremarkable, and the reason serious laboratories run internal standards.
What SELECT reported for HbA1c, and from which baseline
A robust, cheap, standardised assay with a specific and well-catalogued set of failure modes, several of which are common in this population.
The pyrogen question has a price, and it is not the price of a purity run
The absence of microbiological capability in this market is a commercial fact with a straightforward explanation, and it is worth understanding before blaming anybody for it.
The area postrema, and the anatomy of an unwanted effect
What scintigraphy and breath-test studies established about emptying rate, and what they did not.
Where the receptor is: a tissue-by-tissue account of liraglutide’s reach
The central effects are not a bonus. On the current evidence they are the principal mechanism of weight loss.
Carbon-13, and the reason a peptide has more than one mass
A peptide has a monoisotopic mass and an average mass, they differ by several daltons at this molecular size, and a certificate that does not say which it quotes cannot be…
The supply gap as a clinical event
Why the reason for stopping changes what happens afterwards.
The mechanism behind the mechanism
The clinical effect profile is almost fully predictable from where the receptor is expressed, which is unusual and useful.