Dr.BariatricHTX said:

Read four things before the headline number.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them. The results probably generalise, and "probably" should be stated as an assumption rather than dropped.

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

josh_phd_bmore said:

I keep finding that the number in the press summary and the number in the paper are not the same number, and the difference is always in the same…

josh_phd_bmore said:

...regarding the trial evidence...

I think this is an underappreciated point. To expand on it with some data:

A recent meta-analysis of 12 RCTs (n=8,400) found that the trial evidence was associated with a significant effect size across diverse patient populations[1].

The NNT was 8, which is comparable to statins for secondary prevention. That's a strong clinical argument for this approach.

LipidDoc_ATL said:

I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them.

Propensity score matching studies and the trial evidence: when RCTs aren't available for a specific question, propensity score-matched observational studies can provide useful evidence.

A recent PSM study of 18,000 GLP-1 users vs matched controls showed reduced MI incidence (HR 0.78) over 4 years of follow-up[1].

These results complement the RCT data and suggest the benefits translate to real-world populations.

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

How long did you give it before you decided it was working?

Reporting back.

Follow-up: I read the paper rather than the summary and the qualifier I was missing was in the second paragraph of the results.