What SELECT tells us about maintenance, and what it does not
Dose reduction is not withdrawal, and the trials that tested withdrawal cannot be read as testing it.
Imogen Thackeray
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Archive — page 2
61 piecesA unit is not a dose, and it never was
Dead space in the needle hub is a real and calculable loss, and it matters more at small volumes than anybody expects.
The supply gap as a clinical event
Why the reason for stopping changes what happens afterwards.
Four millimetres is enough, and the data says so
The insulin injection-technique literature is large, well conducted and directly transferable on questions of depth and tissue. We say where it stops transferring.
Two-thirds back: the extension nobody expected to be the headline
The evidence on stopping is better than the evidence on almost anything else in this field, because somebody deliberately randomised it.
Falling ferritin is not always falling iron
The panel drawn during a week of vomiting is measuring the vomiting.
The dose that got you here and the dose that keeps you here
Every withdrawal trial compared full dose against nothing. The clinically interesting comparison — full dose against a reduced one — has not been randomised.
The shortage years, and what they taught about interruption
Cost is the modal reason for discontinuation in every dataset we have seen, and it is absent from the clinical literature.
What TRIUMPH-1 tells us about maintenance, and what it does not
Dose reduction is not withdrawal, and the trials that tested withdrawal cannot be read as testing it.
A needle is a single-use instrument
Sharps disposal is a legal obligation in most jurisdictions and a safety obligation everywhere. Household waste is not a route.
Continued treatment against continued placebo: the comparison that settled it
What was withdrawn, from whom, after how long, and what was measured afterwards.
Side effects, cost, supply, target: four reasons with four trajectories
Real-world persistence figures, with their definitions stated, because the definitions are doing most of the work.
What happens when the drug is taken away: three randomised answers
What was withdrawn, from whom, after how long, and what was measured afterwards.
Side effects, cost, supply, target: four reasons with four trajectories
A supply interruption is a discontinuation with no notice, no taper and no plan. That is a distinct clinical situation.
Why your laboratory interval differs from the one in the textbook
A flag is a probability statement about a population. It is not a statement about the person holding the printout.
The supply gap as a clinical event
Why the reason for stopping changes what happens afterwards.
Randomised withdrawal is the cleanest design in this field and the least discussed
The evidence on stopping is better than the evidence on almost anything else in this field, because somebody deliberately randomised it.
The shortage years, and what they taught about interruption
Cost is the modal reason for discontinuation in every dataset we have seen, and it is absent from the clinical literature.
In-use periods, and the ones nobody can give you
Sharps disposal is a legal obligation in most jurisdictions and a safety obligation everywhere. Household waste is not a route.
The shortage years, and what they taught about interruption
Real-world persistence figures, with their definitions stated, because the definitions are doing most of the work.