[Titration] 12 weeks per step is not too slow, it is just unfashionable
The title is the argument: 12 weeks per step is not too slow, it is just unfashionable. Here is the rest of it. Pulling the figures out of the title: 12 weeks. All of it is written down as it happened rather than reconstructed. Research-use-only material is not approved for human use. Anything in this thread about…
SURMOUNT-1 ran 72 weeks with the top arm around 21% mean body weight change. SURPASS is the diabetes programme and reports glycaemic endpoints, so quoting the two interchangeably is a category error.
The four-week interval in the label is a minimum. Nothing about the pharmacology requires you to step on schedule, and the trials stepped on a calendar because trials have to.
Cosigning the four-week thing. It is a minimum interval, and treating it as a schedule to keep up with is how people end up miserable at 12.5.
Weekly dosing again, half-life in the same neighbourhood as sema, so a step change takes about a month to reach steady state. Judging a new step at day five is judging noise.
Held 7.5 for five months. Everyone kept asking when I was going to 10. The answer was never, because 7.5 was working.
the trials titrated on a calendar, real people titrate on symptoms
Agreed, and the trial number is a mean of a very wide distribution — the tails are enormous and nobody posts from the middle.
Same experience with the appetite effect being flatter across the week rather than front-loaded.