What the trials monitored, and what that implies about routine practice
Timing is the whole of the post-cessation panel: draw it too early and it measures the treatment period.
Tirzepatide
Page 2 of 18 of this archive, newest first.
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.
Side effects, cost, supply, target: four reasons with four trajectories
Why the reason for stopping changes what happens afterwards.
Micronutrient monitoring: which panel, how often, and on whose evidence
A monitoring schedule requires evidence about incidence. For this population, that evidence does not exist.
Why a drug that acts on the pancreas changes what food tastes like
Receptor expression maps explain the effect profile better than any dose-response curve.
Target dose, effective dose, and the distance between them
What the trials measured was continuation against withdrawal. What patients want to know is continuation at a lower dose, and that study has largely not been done.
Dual, triple, co-formulated: a taxonomy the coverage keeps collapsing
A dual agonist is one molecule with two receptor activities. A co-formulation is two molecules in one pen. The coverage treats them as synonyms.
The skeleton responds to load, and load is falling
What the Journal would want measured before treating this as settled in either direction.
What the tirzepatide schedule assumes about a person it has never met
What the published pharmacokinetics permit, what the labels state, and where the two diverge.
HbA1c and its lag: what a result three months old is telling you
The assay is not the problem. The interpretation of a lagging integral as a current measurement is the problem.
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.
The lowest effective dose is a real concept with almost no data behind it
A survey of the maintenance evidence, which is shorter than the survey of the withdrawal evidence.
What we would need to measure to explain the response distribution
The mechanism is well described. The variance is not.
The skeleton responds to load, and load is falling
Weight loss reduces bone mineral density at load-bearing sites. Whether that translates into fractures in this population is unmeasured.
The dose that got you here and the dose that keeps you here
A survey of the maintenance evidence, which is shorter than the survey of the withdrawal evidence.
The upper rungs, ranked by evidence
Where the curve flattens, what flattens with it, and what does not.
Target dose, effective dose, and the distance between them
A plateau at an intermediate dose and a plateau at the maximum dose look identical from the outside and mean different things.
One receptor, several signals: the case for reading liraglutide as a biased agonist
Receptor pharmacology explains more of the clinical picture than the dose does — and almost none of it appears in the material patients are given.
Lean mass is a compartment, not a tissue
The instrument determines the answer more than the drug does, and the trade quotes the answer without naming the instrument.
GIP was a failed target for thirty years. Then it was not.
A dual agonist is one molecule with two receptor activities. A co-formulation is two molecules in one pen. The coverage treats them as synonyms.