Dr.PathRoch said:The GIP arm is doing real work rather than padding the label.
Thank you for spelling out the reasoning rather than just the conclusion. Adding it to my notes with a link back to this thread.
From the other side of the consultation, briefly.
Dose-response modeling for tirzepatide: Emax model fitting to the STEP/SURMOUNT dose-finding data shows:
Semaglutide: ED50 ≈ 0.6mg, Emax ≈ -18%, Hill coefficient ≈ 1.3
Tirzepatide: ED50 ≈ 6mg, Emax ≈ -25%, Hill coefficient ≈ 1.5
Clinical implication: most patients achieve >80% of maximal response by the mid-range dose (1.7mg sema, 10mg tirz). Going to the maximum dose provides diminishing returns — possibly not worth the additional side effect burden for some patients. Individualize dosing based on response vs tolerability.
Dr.LeslieOBGYN said:FLOW is the relevant trial and it reported a meaningful reduction in kidney-disease progression and related death in people with type 2 diabetes and…
Pushing back on Dr.LeslieOBGYN here. The counter-case has not been addressed. Somebody upthread described the situation that does not fit, and the thread moved on rather than engaging with it, which is the failure mode this board is supposed to avoid.
Worth separating that from renal function, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.
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View ResultsAdding the numbers, since they settle part of this. One habit that pays for itself: post the method alongside the number. A figure without its method cannot be checked, and an unchecked figure is how this community accumulates folklore.
Worth separating that from renal function, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.