Heart rate increase on sema — what worked for you?

VendorMark said:

The honest answer is that the effect is real, the magnitude is contested, and the individual variation is larger than either.

All true, with one condition: that curve is for people who reached the dose on schedule. Anyone who slowed the ladder for tolerability is on a different, flatter curve, and comparing yourself with the published mean will make you feel like a non-responder when you are not.

sarah_TO said:

Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.

This is exactly what I could not find anywhere else.

VendorMark said:

The honest answer is that the effect is real, the magnitude is contested, and the individual variation is larger than either.

Pushing back on VendorMark here. The trial means are being read too generously in this thread. STEP populations were selected, supported, and titrated by protocol, and the real-world curves are consistently a few points worse. That difference is not noise, it is what happens when you remove the study infrastructure.

Adding the numbers, since they settle part of this. If you are going to change something, change one thing and give it long enough to express itself. Four weeks is the usual minimum for anything pharmacological on this board, and two weeks of data has told you almost nothing.

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