The slide that was not in the abstract

Across 21 presentations at a congress in Wuhan this month, one theme recurred with a persistence that the programme did not anticipate: duration. Not whether these drugs work, which nobody in the room disputed, but for how long they will be taken, by whom, and who pays for the twentieth year.

Of the 21 presentations the Journal attended, 10 addressed treatment duration or discontinuation directly. Two reported registry data on persistence at twelve and twenty-four months, both showing attrition substantially higher than trial discontinuation rates, and both attributing the majority of it to cost and coverage rather than tolerability.

Congresses in this field are heavily sponsored, and the Journal pays its own registration and travel. Where a session was industry-supported we say so, because the sponsorship shapes the programme even where it does not shape the data.

"I see patients with unlabelled vials every month and there is no guidance anywhere that tells me what to do," said Dr Sirichai Boonmee, peptide chemist, Chulalongkorn University. "That session was the first time I have heard it discussed at a podium."

"I see patients with unlabelled vials every month and there is no guidance anywhere that tells me what to do," said Dr Ingrid Haldorsen, clinical epidemiologist. "That session was the first time I have heard it discussed at a podium."

We have requested the underlying persistence dataset from both registry groups and will publish an analysis if it is provided.