[Discussion] dual agonist is doing more work than we give it credit for
The title is the argument: dual agonist is doing more work than we give it credit for. Here is the rest of it. The distribution matters more than the mean. In the trial population the interquartile spread was wide enough that two honest people can have completely different runs on the same arm. Research-use-only…
The four-week interval in the label is a minimum. Nothing about the pharmacology requires you to step on schedule, and the trials stepped on a calendar because trials have to.
The step schedule question, answered properly, because it comes up weekly.
The label sets a minimum interval of four weeks between increases. That is a floor on how fast you may go, and it exists because tolerability, not efficacy, is what limits most people. There is nothing in the pharmacology that says you must increase at four weeks, or at eight, or ever.
What decides it in practice is whether the effect you want is still there. If appetite is quiet and the trend is going the right way, the dose is doing its job. If both have genuinely gone flat for six weeks or more, that is a conversation worth having with someone who knows your history.
if 7.5 is working, 10 is not automatically better
SURMOUNT-1 ran 72 weeks with the top arm around 21% mean body weight change. SURPASS is the diabetes programme and reports glycaemic endpoints, so quoting the two interchangeably is a category error.
zepbound and mounjaro are the same compound with different labels
the trials titrated on a calendar, real people titrate on symptoms
sulphur burps are the signature complaint and they are not dangerous
Yes — 10mg being a genuine landing place for a lot of people is underrated. There is no medal for 15.