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ForumsOral GLP-1 AgonistsRybelsus real-world vs clinical trial efficacy — the gap explained Page 2

Rybelsus real-world vs clinical trial efficacy — the gap explained

BiostatsBrad Thu, May 21, 2026 at 5:35 AM 23 replies 904 viewsPage 2 of 5
anders_CPH
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May 21, 2026 at 7:45 AM#6

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.

28 23CryptoCarl, MariaRD, AussieAnna and 25 others
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robert_kc
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May 21, 2026 at 8:35 AM#7

Following on from hans_munich — and this may be the naive question:

How much of the oral variability is the SNAC absorption window and how much is dose, because the two get conflated constantly?

Last edited: May 21, 2026 at 10:35 AM
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Dr.LeslieOBGYN
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May 21, 2026 at 9:25 AM#8
anders_CPH said:
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.

Adding the part of the answer the thread has not reached. 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.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

26 21james_edin, FranDenver, Dr.BariatricHTX and 23 others
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BiostatsBrad
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May 21, 2026 at 10:15 AM#9

Closing the loop on my own question.

I moved the tablet to the moment I wake up rather than trying to fit it around breakfast, and the difference in the following weeks was obvious. It was a timing problem, not a dose problem.

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TomTeleRx
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May 21, 2026 at 2:14 PM#10
Dr.LeslieOBGYN said:
Relative and absolute effects need reading together.

That is correct as far as it goes, and here is where it stops going. Worth adding that the tablet is taken daily, so a missed dose costs far less than a missed weekly injection. That is a genuine advantage nobody lists.

49 22TrialNerd_Beth, HPLC_Greg, LibrarianMeg and 46 others
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