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ForumsCardiovascular OutcomesSTEP-HFpEF: semaglutide in heart failure with preserved EF Page 2

STEP-HFpEF: semaglutide in heart failure with preserved EF

Dr.CardioMD Mon, Jun 8, 2026 at 2:10 AM 15 replies 378 viewsPage 2 of 3
Dr.NateNeph
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Jun 8, 2026 at 2:37 AM#6

The figures, for anyone assembling their own picture. For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and subcutaneous bioavailability near 89%. Those four numbers explain most of the questions people ask about timing.

Correct me if the detail matters more than I have assumed.

Last edited: Jun 8, 2026 at 4:37 AM
39 9JakeSmashed95, NauseaFreeNow, SteveThurs and 36 others
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josh_phd_bmore
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Jun 8, 2026 at 2:48 AM#7

One thing that is still open after Dr.ReproEndo’s answer:

How much of the between-person variation is pharmacokinetic and how much is just adherence measured badly?

Last edited: Jun 8, 2026 at 4:48 AM
38 8Dr.ObesityLA, NurseKim_ATL, paul_denver and 35 others
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Dr.MetabolicMD
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Jun 8, 2026 at 2:58 AM#8
Dr.NateNeph said:
For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and…

Coming at Dr.NateNeph’s question from a different direction. Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak. People who dose late are not losing a peak, they are letting the trough fall, and the appetite effect tracks the trough.

37 7HealthEcon_DC, PedsEndoPhilly, SleepDoc_PDX and 34 others
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Dr.CardioMD
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Jun 8, 2026 at 3:09 AM#9

Reporting back.

Six weeks on from posting: I stopped reading the weekly number and started reading a four-week average, and the "stall" I opened this thread about was a 1.8kg loss I could not see.

Last edited: Jun 8, 2026 at 9:09 AM
36 6roxy_nash, tony_orlando, Dr.NephBHM_UK and 33 others
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BrianDallas92
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Jun 8, 2026 at 4:00 AM#10
Dr.MetabolicMD said:
Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.

That holds for the injectable. The oral formulation has different absorption behaviour and the dose numbers are not interchangeable, which is worth saying out loud because people quote them as if they were.

Last edited: Jun 8, 2026 at 5:00 AM
36 11GraceAZ_72, carl_compliance, DanielChem_CHI and 33 others
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