help me understand SURMOUNT, I have read the wiki twice
The title is the whole question — help me understand SURMOUNT, I have read the wiki twice — but here is why I am asking.
Discontinuation rates are a tolerability result. A trial with a strong efficacy number and heavy discontinuation is telling you two things and people only quote one.
The registered protocol is public. Comparing the registered primary endpoint with the reported one is a two-minute check and it is how outcome switching gets caught.
Relative risk reduction without the baseline rate is uninterpretable. A large relative reduction on a small absolute risk is a small absolute benefit.
Ask me anything specific. Anything general I will probably get wrong.
best — the order this archive was captured in
Open-label extensions lose their randomisation. Anybody still enrolled at week 104 is a selected group and the numbers describe that group.
Right — trial participants get structured support. Comparing yourself to a trial mean is comparing across two different interventions.
Left up and flaired Trial Data. The publication is linked rather than the coverage, which is what we ask for.
Which trial, and which arm?
That is the 68-week readout, not the 72-week one. Different trial, different duration.
Compared myself to a trial mean for about six months before realising the trial arm had dietitian contact every fortnight.
Cardiovascular outcome trials are powered for events, not for weight, and are typically run in a different population with different inclusion criteria. Reading a weight number out of one is reading a secondary endpoint.
STEP is semaglutide obesity, SURMOUNT is tirzepatide obesity, they are not interchangeable
Absolute or relative risk reduction?
Intention-to-treat analyses everybody randomised regardless of what they did afterwards. Completer analyses only those who finished. The second is systematically more flattering and both are legitimate if labelled.
SELECT was cardiovascular outcomes, not weight