A1C reduction on semaglutide: SUSTAIN program meta-analysis

JenPlateau said:

Worth answering the question that was asked rather than the one behind it.

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.

One concrete data point for the thread. Give anything pharmacological four weeks before you judge it, and give anything measured weekly a four-point rolling average before you call it a trend.

I would rather be corrected than agreed with, if it comes to it.

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

Whether anyone has held at a sub-maximal dose long term and kept the result, or whether the maintenance data only exists at 2.4mg?

Dr.AddMedPHL said:

Give anything pharmacological four weeks before you judge it, and give anything measured weekly a four-point rolling average before you call it a…

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.

Dr.AddMedPHL said:

Give anything pharmacological four weeks before you judge it, and give anything measured weekly a four-point rolling average before you call it a…

Fair, and it stops being fair at the extremes. The middle of the range is well understood; the ends are where the honest answer is that nobody knows.