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Evidence-based GLP-1 & peptide discussion since 2023
ForumsPublic SquareI just want to eat pizza again is that too much to ask — what worked for you? Page 2

I just want to eat pizza again is that too much to ask — what worked for you?

TrialNerd_Beth Tue, Sep 24, 2024 at 11:35 AM 11 replies 1,831 viewsPage 2 of 3
Dr.SportsMedIN
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Sep 24, 2024 at 3:09 PM#6
LarryQC_SD said:
Read four things before the headline number.

Pushing back on LarryQC_SD here. I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them. The results probably generalise, and "probably" should be stated as an assumption rather than dropped.

11 14lucas_SP_BR, lisa_labSD, adam_van and 8 others
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PeptideSynthNJ
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Princeton, NJ
Sep 24, 2024 at 4:32 PM#7
TrialNerd_Beth 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…

Propensity score matching studies and the trial evidence: when RCTs aren't available for a specific question, propensity score-matched observational studies can provide useful evidence.

A recent PSM study of 12,000 GLP-1 users vs matched controls showed reduced all-cause mortality (HR 0.81) over 3 years of follow-up[1].

These results complement the RCT data and suggest the benefits translate to real-world populations.

References:
[1] Registry-based cohort study, pre-print 2024.
12 15NurseAsh_DET, BenResearch_OR, MikeKY_noInsulin and 9 others
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LipidDoc_ATL
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Sep 24, 2024 at 5:55 PM#8
Dr.SportsMedIN said:
I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them.
Dr.SportsMedIN 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 statins for secondary prevention. That's a strong clinical argument for this approach.

13 16AttorneyGrant, DebRD_ATL, KristenIndy and 10 others
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maria_elpaso
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El Paso, TX
Sep 24, 2024 at 7:18 PM#9

One thing that is still open after sarah_nash92’s answer:

What would you measure differently if you were starting again?

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TrialNerd_Beth
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Sep 25, 2024 at 1:57 AM#10

OP back with an update, since a thread like this is useless without one.

Update — my curve sits below the published mean and the explanation is that the trial arm had support I do not have. That was reassuring rather than otherwise.

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