SURPASS-2 was built to answer the stopping question, and it did
What was withdrawn, from whom, after how long, and what was measured afterwards.
Discontinuation
Withdrawal trials, weight regain, maintenance dosing and stopping for cost.
Continued treatment against continued placebo: the comparison that settled it
The evidence on stopping is better than the evidence on almost anything else in this field, because somebody deliberately randomised it.
What the placebo arms of the withdrawal trials actually tell us
The evidence on stopping is better than the evidence on almost anything else in this field, because somebody deliberately randomised it.
Side effects, cost, supply, target: four reasons with four trajectories
Why the reason for stopping changes what happens afterwards.
The lead-in, the randomisation, and the year that followed
Three randomised withdrawal designs have tested what happens when treatment stops. Their results are consistent and they are consistently misreported.
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.
Continued treatment against continued placebo: the comparison that settled it
The regain trajectories, arm by arm, with the estimands named.
A design note on withdrawal trials, and why the run-in matters
The evidence on stopping is better than the evidence on almost anything else in this field, because somebody deliberately randomised it.
REWIND was built to answer the stopping question, and it did
Three randomised withdrawal designs have tested what happens when treatment stops. Their results are consistent and they are consistently misreported.
Side effects, cost, supply, target: four reasons with four trajectories
The trials studied planned withdrawal. Almost nobody stops that way.
Coming off: what the pharmacology permits
What a slow reduction could plausibly buy, and what it certainly cannot prevent.
What SURMOUNT-3 tells us about maintenance, and what it does not
The commonest real-world strategy in this drug class is the least studied one.
What happens when the drug is taken away: three randomised answers
Three randomised withdrawal designs have tested what happens when treatment stops. Their results are consistent and they are consistently misreported.
Maintenance dosing: what is licensed, what is practised, and what is evidenced
Every withdrawal trial compared full dose against nothing. The clinically interesting comparison — full dose against a reduced one — has not been randomised.
Why people actually stop, in the order they actually stop
A supply interruption is a discontinuation with no notice, no taper and no plan. That is a distinct clinical situation.
What happens when the drug is taken away: three randomised answers
A withdrawal trial answers a narrower question than it appears to. This piece states which question.
The shortage years, and what they taught about interruption
A supply interruption is a discontinuation with no notice, no taper and no plan. That is a distinct clinical situation.
The supply gap as a clinical event
A supply interruption is a discontinuation with no notice, no taper and no plan. That is a distinct clinical situation.
Every fortnight, every third week, seasonally: an unstudied practice
What the exposure arithmetic says about a fortnightly schedule, and where the arithmetic stops being informative.
The lowest effective dose is a real concept with almost no data behind it
What the labels permit, what clinicians do, and the size of the gap between them.