how much of what we believe about endpoint actually comes from TRIUMPH threads
how much of what we believe about endpoint actually comes from TRIUMPH threads. I would rather ask a basic question now than get this wrong quietly for two months.
Spent an evening with the appendix tables and found the subgroup detail that the entire thread had been speculating about.
Quoted a figure here confidently, got asked whether it was ITT, went and checked, and it was not. Learned something.
Read a press release and the publication three months apart. The hedging in the second one was substantial.
Please do not ask me what dose you should be on. I genuinely do not know and neither does anyone else here.
best — the order this archive was captured in
Intention-to-treat analyses everybody randomised regardless of what they did afterwards. Completer analyses only those who finished. The second is systematically more flattering and both are legitimate if labelled.
Intention-to-treat analyses everybody randomised regardless of what they did afterwards.
Agreed. And the interval, not the point estimate, is what the trial actually established.
Intention-to-treat analyses everybody randomised regardless of what they did afterwards.
This is the distinction that would end about half the arguments on this board.
Correction: SURMOUNT is the obesity programme and SURPASS is the diabetes one. The figure you quoted belongs to the other one.
Small fix — that was the cardiovascular outcomes trial, so weight was a secondary endpoint and the population was different.
Do you have the publication or the press release?
read the endpoint before you read the headline
registry entry, protocol, publication — three different documents
Discontinuation rates are a tolerability result. A trial with a strong efficacy number and heavy discontinuation is telling you two things and people only quote one.
the confidence interval is the finding, the point estimate is the headline
intention to treat versus completers changes the number substantially
Press-release posts get their own flair here. Nothing wrong with them, they are just a different kind of claim.
phase 2 finds a dose, phase 3 measures the effect
FLOW was kidney outcomes and it is the one nobody quotes
the appendix is where the interesting tables live
That is a relative risk reduction. Quoting it without the absolute numbers overstates the case considerably.
Relative risk reduction without the baseline rate is uninterpretable. A large relative reduction on a small absolute risk is a small absolute benefit.
Cosigning on discontinuation. It is a result about tolerability and it gets buried every time.
open-label extensions are not the same evidence as the randomised phase
Right — trial participants get structured support. Comparing yourself to a trial mean is comparing across two different interventions.
Open-label extensions lose their randomisation. Anybody still enrolled at week 104 is a selected group and the numbers describe that group.
a press release is not a publication
Agreed on comparators. "Superior" means nothing until you know superior to what and at what dose.
The press release said that; the publication says something more hedged. Worth reading both.
STEP is semaglutide obesity, SURMOUNT is tirzepatide obesity, they are not interchangeable
That is the 68-week readout, not the 72-week one. Different trial, different duration.
check who the comparator was before you compare anything
- 1Intention-to-treat analyses everybody randomised regardless of what they did…8 comments in this branch · started by u/sanne_laurent
- 2the appendix is where the interesting tables live8 comments in this branch · started by u/draw_up_dizzy