[Discussion] we are measuring SURPASS at the wrong time and calling it noise
we are measuring SURPASS at the wrong time and calling it noise — a position I have arrived at slowly and would like tested.
Vials and pens carry the same molecule; what differs is fill volume, device tolerance and whether you are doing your own arithmetic. Neither is inherently more accurate.
Held 7.5 for five months. Everyone kept asking when I was going to 10. The answer was never, because 7.5 was working.
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.
If somebody has the same thing measured a different way, post it next to mine and we will see whether they agree.
best — the order this archive was captured in
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.
The step schedule question, answered properly, because it comes up weekly.
This. The step interval is a floor, and reading it as a timetable is the most expensive mistake in the thread.
sulphur burps are the signature complaint and they are not dangerous
Weekly dosing again, half-life in the same neighbourhood as sema, so a step change takes about a month to reach steady state. Judging a new step at day five is judging noise.
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.
Did you come to this from sema, and if so how long was the gap?
the appetite effect is blunter than sema, in a good way, most weeks
Does reflux follow the day after the shot, or is it spread across the week?
Pen or vial? The step sizes available differ and it changes this answer.
The thing nobody warned me about was how much of this is logistics — storing it, remembering it, the same day every week.
the four-week step schedule is the label, not folklore
Correction to my own post above — I said 15mg and I have been on 2.5mg since the spring. Same argument, wrong number.