SURMOUNT-4 was built to answer the stopping question, and it did
The regain trajectories, arm by arm, with the estimands named.
Recent work
182 piecesWhat a month without the drug does to tolerability
Concentrations fall by half a week, so a month away leaves a small fraction of steady state. Resuming at the previous dose presents the receptor with a step it has not seen…
What we would need to randomise to answer this properly
The older-adult diet-and-exercise trials are the closest analogue to rapid pharmacological weight loss, and they are twenty years old.
The restart nobody plans for
The convention — resume lower, re-escalate — is not caution. It follows directly from the elimination half-life.
Seven days, four weeks, one number: how liraglutide exposure actually accumulates
Half-life, accumulation ratio and time to steady state are three separate quantities, and confusing them produces most of the bad advice in circulation.
What the outcome trials measured in the kidney
Asymptomatic pancreatic enzyme elevation is common on treatment and is not pancreatitis. The distinction is clinical, not biochemical.
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…
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 specification sheet says 500,000. The report says conforms.
Every instrument specification quoted in an advertisement is a best case obtained on a calibration mixture, not on a submitted vial.
What the GIP receptor adds: reading cagrilintide as two drugs in one sequence
Head-to-head data exists for some of these comparisons and not for others. This piece says which.
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.
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.
STEP 8 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.
Choosing a needle for a subcutaneous peptide
Skin thickness at the standard injection sites is approximately two millimetres in adults and varies remarkably little with body mass. That single finding is why short…
Beta-arrestin, cAMP, and the part of cagrilintide’s mechanism nobody quotes
Selectivity, potency and efficacy are three different measurements. The trade routinely reports none of them.
SUSTAIN-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.
How a release document is put together in a regulated plant
Nothing on this page is difficult. It is simply unfamiliar, and unfamiliarity is what makes a weak certificate look like a strong one.
SURMOUNT-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.
SURPASS-4 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.
Seasonal use, holiday use, and the honest state of the evidence
A great deal of practice has grown up around intermittent schedules. The randomised evidence for any of them is, as far as the Journal can establish, nil.