Short answer first, then the reasoning. Read four things before the headline number. The population, because trial populations are selected and supported in ways that real cohorts are not. The comparator, because "better than placebo" and "better than the current standard" are different claims and get reported identically. The primary endpoint as pre-registered, because a secondary endpoint promoted after the fact is a hypothesis rather than a finding. And the completion rate, because a large effect in the half of participants who finished is a different result from a large effect in everybody enrolled.
Reading the phase 2 write-up next to the injectable trials, and the comparison people keep making does not survive putting the two protocols side by side.
The narrow version of the question is whether a non-peptide oral agonist can match injectable exposure in practice, or whether the convenience is bought with a lower ceiling.
Happy to be told the question itself is wrong.
PharmacoVig_BOS said:Read four things before the headline number.
PharmacoVig_BOS has the substance of this right. The condition it depends on is worth stating. The manufacturing argument is the underrated one. Peptide synthesis capacity has been the binding constraint on this entire class, and a small molecule is made in ordinary chemical plants. If it holds up in phase 3, the supply and price picture changes more than the efficacy picture does.
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Browse GL BiochemNurseKim_ATL said:Reading the phase 2 write-up next to the injectable trials, and the comparison people keep making does not survive putting the two protocols side by…
Agreed, and subgroup analyses deserve particular suspicion. With enough subgroups something is significant by chance, and pre-registered subgroups are a different animal from ones found afterwards.
Adding the clinical framing, because it changes how the question reads. It helps to ask what evidence would change your mind before you look at any. If nothing would, the discussion is not about evidence, and it is better to say so early than to spend nine posts discovering it.