SURPASS — 12 things I got wrong before I got it right
Thinking out loud about this: SURPASS — 12 things I got wrong before I got it right.
Started keeping the trial identifiers straight in a note file because I kept mixing up two programmes in the same sentence.
Went looking for the registered protocol to see whether the endpoint had changed. It had not, which was reassuring and worth checking.
The discontinuation numbers were the most useful thing in the paper for me and they were in a supplementary table.
If two or three other people have done the same thing we might actually learn something. Alone it is an anecdote.
best — the order this archive was captured in
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.
Not convinced. Cross-trial comparison between two programmes with different populations and designs is not a comparison.
That is the 68-week readout, not the 72-week one. Different trial, different duration.
This. Intention-to-treat versus completer analysis routinely moves the headline by several points.
Is that intention-to-treat or completers?
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Agreed. Half the arguments on this site are two people quoting different trials at each other without noticing.
Push back: an open-label extension tells you about the people who stayed. That is a different question.
Same. A press release is a claim about a result; the publication is the result.
SURPASS is the diabetes programme and reports glycaemic endpoints
The registered protocol is public. Comparing the registered primary endpoint with the reported one is a two-minute check and it is how outcome switching gets caught.
Left up and flaired Trial Data. The publication is linked rather than the coverage, which is what we ask for.
Left up and flaired Trial Data.
Agreed. And the interval, not the point estimate, is what the trial actually established.
Agreed on comparators. "Superior" means nothing until you know superior to what and at what dose.
Small fix — that was the cardiovascular outcomes trial, so weight was a secondary endpoint and the population was different.
Open-label extensions lose their randomisation. Anybody still enrolled at week 104 is a selected group and the numbers describe that group.
Disagree — that figure is from the diabetes programme and you are quoting it as an obesity endpoint.
Careful with that mean. The distribution around it was wide enough that it describes very few individual participants.
Correction: SURMOUNT is the obesity programme and SURPASS is the diabetes one. The figure you quoted belongs to the other one.
Spent an evening with the appendix tables and found the subgroup detail that the entire thread had been speculating about.
How long was the randomised phase before any extension?
- 1Open-label extensions lose their randomisation. Anybody still enrolled at…6 comments in this branch · started by u/marit_laurent