Rybelsus real-world vs clinical trial efficacy — the gap explained

hans_munich said:

The OASIS programme put 50mg oral in the same territory as 2.4mg injectable — around 15% mean weight loss — but it needed a dose 20 times larger to…

Thank you — that is the clearest version of this I have read, and I have read a lot of them. Adding it to my notes with a link back to this thread.

Adding the clinical framing, because it changes how the question reads. It is worth asking what the claim would look like if it were false. If nothing would look different, it is not a claim about the world and no amount of discussion will settle it.

Worth separating that from the trial evidence, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.

Dr.LeslieOBGYN said:

Relative and absolute effects need reading together.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them. The results probably generalise, and "probably" should be stated as an assumption rather than dropped.

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.

I would rather be corrected than agreed with, if it comes to it.

Moderator note: the sourcing question belongs in the vendor section and has been split out. Tagging this one for the weekly digest.