Thank you for the nice discussion on the ESSENCE trial. I like the comment on DCCT trial - metabolic memory! I was trying to sort out the potential influence of the differential missingness on the primary endpoints for over 10% of patients in each treatment group. 42 patients in the placebo group with missing data on the primary endpoint seems high when about 60 of the 266 had the endpoint (reduction in liver fibrosis with no worsening of steatohepatitis). I see they used multiple imputation so the 42 patients are likely spread out over the 266 for the placebo group. Just curious what you or others thought about the missing data. Looking forward to more from "This Fortnight in Medicine" series!
Hi everybody. Thanks for the post. I’m out here on the front line working as an internist. There is no automatic weight loss with GLP1 receptor agonists. For hundreds of years, physicians have tried to medicalize a disease that has not only a physical, but an emotional and a spiritual component. But there is a solution.
Love it guys. I can see your excitement about GLP1 meds. I share some, but temper it, because I can't remember a "miracle" drug that was touted as effective for many conditions which didn't end up having serious down sides. We'll see.
I agree that "telling people to just diet and exercise more" is not a useful alternative treatment. A public health intervention which requires almost everybody to adhere to is not a useful public health intervention. And it seems to generate strong moralistic reactions for some reason.
The GLP-1 RA group lost much more weight than the control group. Is it the drug that was responsible for the improvement or the weight loss? It sems to me that a group that lost weight without semaglutide would have been a better control group. Either weight loss through diet/exercise or bariatric surgery or both.
Thank you for the nice discussion on the ESSENCE trial. I like the comment on DCCT trial - metabolic memory! I was trying to sort out the potential influence of the differential missingness on the primary endpoints for over 10% of patients in each treatment group. 42 patients in the placebo group with missing data on the primary endpoint seems high when about 60 of the 266 had the endpoint (reduction in liver fibrosis with no worsening of steatohepatitis). I see they used multiple imputation so the 42 patients are likely spread out over the 266 for the placebo group. Just curious what you or others thought about the missing data. Looking forward to more from "This Fortnight in Medicine" series!
Hi everybody. Thanks for the post. I’m out here on the front line working as an internist. There is no automatic weight loss with GLP1 receptor agonists. For hundreds of years, physicians have tried to medicalize a disease that has not only a physical, but an emotional and a spiritual component. But there is a solution.
Friend of Bill W.
Love it guys. I can see your excitement about GLP1 meds. I share some, but temper it, because I can't remember a "miracle" drug that was touted as effective for many conditions which didn't end up having serious down sides. We'll see.
I agree that "telling people to just diet and exercise more" is not a useful alternative treatment. A public health intervention which requires almost everybody to adhere to is not a useful public health intervention. And it seems to generate strong moralistic reactions for some reason.
This was better than sliced bread. Excellent discussion with practical considerations.
The GLP-1 RA group lost much more weight than the control group. Is it the drug that was responsible for the improvement or the weight loss? It sems to me that a group that lost weight without semaglutide would have been a better control group. Either weight loss through diet/exercise or bariatric surgery or both.