LipidDoc_ATL said:The gap between trial results and real-world results is consistent and it is not fraud.
This is where I part company with the consensus forming above. Two drugs, two side-effect profiles, one price. The efficiency argument only works if the tolerability really is better than dose-escalating a single agent, and I have not seen that demonstrated head to head.
Worth separating that from the trial evidence, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.
One concrete data point for the thread. A quick sanity check on any figure quoted here: is it mean or median, is it intention-to-treat or completers, and what was the comparator. Three questions, and they resolve most disagreements in these threads.
HPLC_Greg said:Two drugs, two side-effect profiles, one price.
Coming at HPLC_Greg’s question from a different direction. Read four things before the headline number. The population, because trial populations are selected and supported in ways that real cohorts are not. The comparator, because "better than placebo" and "better than the current standard" are different claims and get reported identically. The primary endpoint as pre-registered, because a secondary endpoint promoted after the fact is a hypothesis rather than a finding. And the completion rate, because a large effect in the half of participants who finished is a different result from a large effect in everybody enrolled.
Happy to go further on any of that.
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View ResultsA narrower follow-up, since the general answer is now clear:
How to read a result like this without either dismissing it or over-reading it, since the summaries all read like press releases?
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.