Dr.ReproEndo said:Read four things before the headline number.
This is where I part company with the consensus forming above. 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.
RetaRick_CA 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.
[1] Registry-based cohort study, pre-print 2024.
FDA_TrackerJim said:I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them.
FDA_TrackerJim said:...regarding the trial evidence...
I think this is an underappreciated point. To expand on it with some data:
A recent meta-analysis of 12 RCTs (n=8,400) found that the trial evidence was associated with a significant effect size across diverse patient populations[1].
The NNT was 8, which is comparable to antihypertensives for stroke reduction. That's a strong clinical argument for this approach.
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Shop Reference StandardsFollowing on from hannah_MT — and this may be the naive question:
What would you measure differently if you were starting again?
Reporting back.
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.