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Evidence-based GLP-1 & peptide discussion since 2023
ForumsClinical Trials & ResearchSTEP-HFpEF: semaglutide in heart failure with preserved EF — looking for input Page 3

STEP-HFpEF: semaglutide in heart failure with preserved EF — looking for input

amy_econ_NJ Thu, Mar 19, 2026 at 12:16 PM 12 replies 732 viewsPage 3 of 3
NeuroNate
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Mar 20, 2026 at 1:40 AM#11
VendorMark said:
The mechanism that matters here is not stomach emptying, it is central.

Agreed, though "tolerable" needs defining. A dose you tolerate by eating almost nothing is not tolerated, it is being paid for somewhere else — usually in lean mass, sometimes in adherence three months later.

20 20jason_paloalto, Dr.LeslieOBGYN, MikeNYC_runner and 17 others
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B12Beth
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Mar 20, 2026 at 5:59 AM#12
Dr.DermMIA said:
The oral formulation has different absorption behaviour and the dose numbers are not interchangeable, which is worth saying out loud because people…

This answered a question I did not know how to ask. Adding it to my notes with a link back to this thread.

19 19carl_compliance, DanielChem_CHI, marco_milano and 16 others
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SleepFixSam
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Mar 20, 2026 at 10:18 AM#13
VendorMark said:
The mechanism that matters here is not stomach emptying, it is central.

Pushing back on VendorMark here. 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.

18 18raj_cambridge, ingrid_STO, pete_nash and 15 others
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wendy_avl
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Mar 20, 2026 at 2:37 PM#14
amy_econ_NJ said:
Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.
amy_econ_NJ said:
...cardiovascular risk is just another fad...

I understand the skepticism — we've all seen "miracle" weight loss solutions come and go. But consider what makes GLP-1 agonists different:

  • Phase 3 RCTs with thousands of participants (not 20-person pilot studies)
  • Published in NEJM, JAMA, Lancet (not press releases)
  • Replicated across multiple independent research groups
  • Proven cardiovascular and renal benefits beyond weight loss
  • Biological mechanism fully characterized at the receptor level

This isn't a fad — it's a new drug class supported by the highest level of clinical evidence. The comparison to past fads is understandable but inappropriate.

Last edited: Mar 20, 2026 at 8:37 PM
17 17PharmHunterJen, TomTeleRx, DoseLogDan and 14 others
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Admin
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Mar 20, 2026 at 6:56 PM#15

Moderator note: two posts asking for a source have been merged into one. Please search the thread before asking again. Thread quality here is what the rules are for. Keep it up.

Last edited: Mar 20, 2026 at 10:56 PM
16 16PeptideSynthNJ, Dr.KarenChen, Dr.NateNeph and 13 others
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