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ForumsPublic SquareHas anyone dealt with novo nordisk vs eli lilly?

Has anyone dealt with novo nordisk vs eli lilly?

tom_AK Sat, Feb 22, 2025 at 8:01 PM 6 replies 1,534 viewsPage 1 of 2
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tom_AK
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Feb 22, 2025 at 8:01 PM#1

My own curve sits about four points below the published mean and I spent two months assuming that meant something was wrong with me or with my material.

What I actually want to know is how to read a result like this without either dismissing it or over-reading it, since the summaries all read like press releases.

Practical detail welcome, however dull — the duller the better.

40 18steve_okc, dave_SLC, FDA_TrackerJim and 37 others
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MikeFit_NJ
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Feb 22, 2025 at 8:19 PM#2

Taking the question as asked, rather than the general version of it. Relative and absolute effects need reading together. A 20% relative reduction on a high baseline risk is a large absolute benefit; the same relative figure on a low baseline risk is a small one, and press summaries almost always quote the relative number because it is bigger.

Last edited: Feb 22, 2025 at 11:19 PM
41 19marcus_mpls, DeniseRN_TPA, SandraNC_45 and 38 others
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A1cHero_PHX
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Feb 22, 2025 at 8:37 PM#3
MikeFit_NJ said:
Relative and absolute effects need reading together.

Bayesian meta-analysis perspective on the trial evidence: traditional frequentist meta-analyses report point estimates and confidence intervals. Bayesian approaches provide probability distributions that are more intuitive for clinical decision-making.

For example: "There is a 98.5% probability that semaglutide 2.4mg produces >10% weight loss vs placebo" is more actionable than "RR 3.4, 95% CI 2.8-4.1, p<0.001."

The the trial evidence evidence is strong under both frameworks, but Bayesian analysis better communicates the degree of certainty for individual patient counseling.

42 20tampaLisa73, KarenAZ_mom, zoe_NC and 39 others
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sean_dublin
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Feb 22, 2025 at 8:55 PM#4
tom_AK said:
My own curve sits about four points below the published mean and I spent two months assuming that meant something was wrong with me or with my…

Can confirm the pattern tom_AK describes. The gap between trial results and real-world results is consistent and it is not fraud. Trial participants get titration by protocol, scheduled contact, free drug and dietetic support; removing that infrastructure costs a few percentage points every time it has been measured. When your own curve sits below the published mean, that is the likeliest explanation before anything about you or your material.

43 21NurseLeah_Nash, gary_naperville, sean_dublin and 40 others
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Dr.PeteFamMed
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Feb 22, 2025 at 10:34 PM#5

Clinical perspective, offered as context rather than as advice.

tom_AK said:
...regarding the trial evidence...

I think this is an underappreciated point. To expand on it with some data:

A recent meta-analysis of 18 RCTs (n=15,600) found that the trial evidence was associated with a robust effect size across diverse patient populations[1].

The NNT was 15, which is comparable to antihypertensives for stroke reduction. That's a strong clinical argument for this approach.

Last edited: Feb 22, 2025 at 11:34 PM
44 22FranDenver, Dr.BariatricHTX, LindaRN_retired and 41 others
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