Dr.PathRoch said:Steady state is the thing most people miss.
Saving this. It is the first explanation that did not require me to already understand it. Adding it to my notes with a link back to this thread.
From the other side of the consultation, briefly.
nick_SD_fit said:...but the FDA says semaglutide...
Interesting point. I want to add some regulatory nuance: the FDA labeling reflects the specific clinical trial data submitted for approval. Real-world clinical practice often extends beyond the FDA label based on emerging evidence and clinical judgment.
Example: semaglutide was first approved for diabetes (Ozempic), then obesity (Wegovy). The molecule didn't change — our understanding of its applications expanded. Similarly, semaglutide may evolve as more data accumulates.
LibrarianMeg said:The mechanism that matters here is not stomach emptying, it is central.
Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. The trial means are being read too generously in this thread. STEP populations were selected, supported, and titrated by protocol, and the real-world curves are consistently a few points worse. That difference is not noise, it is what happens when you remove the study infrastructure.
Correct me if the detail matters more than I have assumed.
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Browse GL BiochemThe figures, for anyone assembling their own picture. With resmetirom now available for MASH, combination approaches are being explored, so the standard of care in this area is moving faster than most threads assume.