Clinical perspective, offered as context rather than as advice. 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.
One thing that is still open after claudia_zurich’s answer:
How much of the between-person variation is pharmacokinetic and how much is just adherence measured badly?
Dr.ObesityMed said:It is worth asking what the claim would look like if it were false.
Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. Steady state is the thing most people miss. The terminal half-life is about a week, so every dose step takes four to five weeks to fully express itself. Judging a step at day ten is judging the ascent, not the plateau, and it is the single commonest reason people escalate before they needed to.
Happy to go further on any of that.
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Browse GL BiochemDr.ObesityMed said:It is worth asking what the claim would look like if it were false.
That is correct as far as it goes, and here is where it stops going. Yes, and the corollary is less popular: if the reasoning holds, it also holds where it produces an answer we do not like.
Moderator note: reminder that nothing in this thread is medical advice, and that clinical claims need a source. No action needed from anybody.