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ForumsPublic SquareSELECT trial 4-year follow-up data released — anyone have experience?

SELECT trial 4-year follow-up data released — anyone have experience?

NurseKim_ATL Fri, Aug 30, 2024 at 7:58 AM 10 replies 1,790 viewsPage 1 of 2
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NurseKim_ATL
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Atlanta, GA
Aug 30, 2024 at 7:58 AM#1

Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.

The bit I cannot resolve on my own is how much of the SELECT benefit is plausibly independent of the weight loss, and whether that distinction changes anything practical.

Numbers rather than impressions, if you have them.

4 7denise_HTX, raj_cambridge, ingrid_STO and 1 other
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LibrarianMeg
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Aug 30, 2024 at 8:19 AM#2

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.

I would rather be corrected than agreed with, if it comes to it.

5 8PharmD_Rodriguez, julia.endo, JessicaM_2024 and 2 others
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denise_HTX
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Houston, TX
Aug 30, 2024 at 8:40 AM#3
LibrarianMeg said:
Read four things before the headline number.

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.

6 9JessicaH_TX, KevinCompounds, TirzTom and 3 others
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hannah_MT
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Bozeman, MT
Aug 30, 2024 at 9:01 AM#4
NurseKim_ATL said:
Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.

Adding a me-too, because a thread of one person's experience is not much use.

7 10PurityPaulOR, MaxMetOK, MounjBrad and 4 others
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NurseLeah_Nash
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Sep 2024
Nashville, TN
Aug 30, 2024 at 10:54 AM#5

Adding the clinical framing, because it changes how the question reads.

Positive "side effect" of cardiovascular risk: my blood pressure dropped so much that I'm now off amlodipine entirely! My cardiologist is thrilled.

If you're on BP meds and losing weight on a GLP-1, monitor your BP at home regularly. Hypotension symptoms (dizziness, lightheadedness when standing) mean your BP meds may need reduction. Don't wait for your next scheduled appointment — call your doctor.

8 11Dr.NateNeph, PharmD_Rodriguez, julia.endo and 5 others
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