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ForumsOral GLP-1 AgonistsRybelsus real-world vs clinical trial efficacy — what worked for you? Page 2

Rybelsus real-world vs clinical trial efficacy — what worked for you?

B12Beth Wed, Jul 30, 2025 at 2:53 AM 15 replies 1,558 viewsPage 2 of 3
PharmD_Rodriguez
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Jul 30, 2025 at 4:54 AM#6
PeptideChemSF said:
Orforglipron is the more interesting oral story because it is not a peptide at all.

I do not accept that the fasting window is a minor inconvenience. Adherence data on daily orals with timing requirements is consistently worse than weekly injections, and a drug you take imperfectly is a lower dose than the one on the box.

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Dr.PeteFamMed
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Jul 30, 2025 at 5:41 AM#7

The figures, for anyone assembling their own picture. 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.

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.

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Dr.DermMIA
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Jul 30, 2025 at 6:28 AM#8
PharmD_Rodriguez said:
I do not accept that the fasting window is a minor inconvenience.

Coming at PharmD_Rodriguez’s question from a different direction. 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.

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hans_munich
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Jul 30, 2025 at 7:15 AM#9

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

Whether the fasting requirement is as strict in practice as the label implies, and what people actually see when they get it wrong?

Last edited: Jul 30, 2025 at 1:15 PM
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B12Beth
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Jul 30, 2025 at 11:03 AM#10

Reporting back.

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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