u/renzo_yildiz

Correction: that is the imaging endpoint, not the histological one. The paper reports both and they differ substantially.

A certificate of analysis is a document describing one batch: what was tested, by what method, and what the result was. Its value depends entirely on whether it names the batch and the method.

the TRIUMPH programme is still running, so anything definitive is premature

Biopsy-confirmed population or imaging-selected?

Asked here what the difference was between the imaging and biopsy endpoints and got a genuinely excellent answer.

wait for phase 3 before you argue about rankings

Looked for independent results across this whole site and found almost none. Worth knowing before forming an opinion.

The phase 2 readout ran to 48 weeks in a few hundred participants with a slow escalation. Both the size and the duration matter when people quote the headline number.

titration means going slow on the way up

Not convinced. Imaging-based fat fraction is not the same as a histological response and the paper is explicit about that.

It is a dual agonist at the GLP-1 and glucagon receptors. The glucagon arm is associated with increased energy expenditure and with effects on hepatic fat, which is why the development programme is oriented towards liver disease.

Increases in heart rate have been reported across this receptor class. The magnitude and clinical significance are exactly what phase 3 is powered to establish.

dose escalation in the trials was slow for a reason

Nothing on this board is legal advice. Where a notice carries a deadline or a consequence, that is a matter for somebody qualified in your own jurisdiction.

Read the phase 2 paper twice before ordering anything. Recommend that to anyone in this board: the error bars are the interesting part.

Took three weeks to understand titration and about ten seconds once somebody explained it as a tolerance ladder.

heart rate is the thing people report watching

Kept a log specifically because there is so little published. It is one person and it is not data.

nothing in this board is legal advice

Are you tracking heart rate at all?

the rules differ between neighbouring countries and change by year

Adding the standing caveat — nothing here is legal advice and this one genuinely warrants somebody qualified.

week two with nothing happening is normal

Careful with the rankings. A phase 2 result and a phase 3 result are not on the same evidential footing and cannot be listed in one table.

dose escalation in the trials was slow for a reason

Asked the supplier what documentation travels with the shipment and got a straight answer. That was reassuring in itself.

Not convinced. You are attributing a week of sulphur burps to the glucagon arm when the escalation rate alone would explain it.

week two with nothing happening is normal

britta_boateng has explained this better than the wiki does, which is saying something.

Phase 2 in a biopsy-confirmed population is a demanding design: recruitment is slow, the population is specific, and the results do not generalise to people who have not been characterised that way.

personal import rules are not the same as commercial import rules

Small fix — three receptors, not two. GLP-1, GIP and glucagon, and the third one is the reason this compound gets its own board.

What is the source for that figure — the published paper or a summary of it?

Phase 2 estimates effect and finds a dose range. Phase 3 estimates it precisely in a bigger population and catches what phase 2 was too small to see. Treating them as the same tier of evidence is the recurring error here.

That is body weight change, not fat mass. The trials report the first and people quote it as the second.

Asked somebody qualified locally rather than relying on this board. Best forty minutes I have spent on the topic.

the titration in the trials was slow and deliberate

wait for phase 3 before you argue about rankings

comparing reta phase 2 to sema phase 3 is comparing different things

Same. Very thin independent data on this one, which should make everybody here more tentative than they are.

Nothing on this board is medical advice, and the people answering you — including me — are members with spreadsheets rather than clinicians.

research-use-only material is not approved for human use, full stop