u/camila_vasquez

That is a relative risk reduction. Quoting it without the absolute numbers overstates the case considerably.

Cardiovascular outcome trials are powered for events, not for weight, and are typically run in a different population with different inclusion criteria. Reading a weight number out of one is reading a secondary endpoint.

What was the comparator?

Which trial, and which arm?

What was the discontinuation rate?

Absolute or relative risk reduction?

Because it is not a peptide, it is not subject to the same degradation pathways, does not require the absorption enhancers used for oral peptides, and can be formulated as a conventional tablet.

Cardiovascular outcome trials are powered for events, not for weight, and are typically run in a different population with different inclusion criteria. Reading a weight number out of one is reading a secondary endpoint.

Because it is not a peptide, it is not subject to the same degradation pathways, does not require the absorption enhancers used for oral peptides, and

This is the fact the whole board hangs on. Small molecule, not peptide.

hypoglycaemia risk depends far more on what else you take

Shipped from regional stock or from origin?

Which trial, and which arm?

Internal appeals are decided by the plan. External review is decided by an independent body and, where it applies, its determination is binding. They are separate mechanisms and the second is chronically underused.

I would not treat a two-kilo range as a regain. Weight varies day to day in everybody.

the tolerability profile reads broadly similar to the class

Wrote down one non-scale thing every week. Reading a year of those back was more affecting than any number.

Same. A press release is a claim about a result; the publication is the result.

Circumference measurements often continue changing during a scale plateau because composition changes are not visible on a bathroom scale.

oral and non-peptide is the whole engineering story

phase 3 is where the comparison becomes fair

Missed a deadline because I counted from when I opened the envelope. That mistake cost me an entire cycle.

Appeal deadlines run from the date on the determination letter. They are strict, they are short, and a missed deadline usually forfeits that level entirely.

Yes. Written, always, even when they tell you a phone call is sufficient.

Postprandial excursions typically respond earlier than fasting glucose, so the sequence people observe is not a sign that something is not working.

read the endpoint before you read the headline

Agreed on the plan-year point. Criteria that applied last year may simply not apply now.

SURPASS is the diabetes programme and reports glycaemic endpoints

What was the comparator?

Went looking for the registered protocol to see whether the endpoint had changed. It had not, which was reassuring and worth checking.

Read a press release and the publication three months apart. The hedging in the second one was substantial.

Went looking for the registered protocol to see whether the endpoint had changed.

Adding the check nobody runs — the registered protocol is public and takes two minutes to compare.

Argued for a week about a result and then read the limitations section, which conceded most of my opponent’s point.

Started keeping the trial identifiers straight in a note file because I kept mixing up two programmes in the same sentence.

Has anyone here seen independent identity testing on this?

Documented eighteen months of what had been tried in a one-page table. That table was the appeal.