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ForumsCardiovascular OutcomesHeart failure hospitalization reduction on semaglutide — need advice Page 2

Heart failure hospitalization reduction on semaglutide — need advice

cory_ATX Thu, Jan 9, 2025 at 8:52 AM 12 replies 1,708 viewsPage 2 of 3
NicoleRaleigh
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Jan 9, 2025 at 11:10 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.

5 8InsuranceTom, WendyG_ATL, SaraMom3 and 2 others
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KetoKyle
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Jan 9, 2025 at 12:04 PM#7

Following on from julia.endo — and this may be the naive question:

What the dose-response curve actually looks like above 1.7mg, because the trial means hide how few people account for the extra loss?

6 9JenMemphis, pat_auckland, Dr.GastroMayo and 3 others
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BariatricNurseD
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Jan 9, 2025 at 12:58 PM#8
NicoleRaleigh 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…

There is a second half to this that has not been said yet. The dose-response is real but shallow at the top. Across STEP 1 and STEP 4 the gap between 1.7mg and 2.4mg is a couple of percentage points of body weight on average, and the average is carrying a wide spread — plenty of people at 1.7mg sit above the 2.4mg mean. If a dose is working and tolerable, "working" is the relevant variable, not "maximal".

7 10josh_phd_bmore, roxy_nash, tony_orlando and 4 others
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cory_ATX
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Jan 9, 2025 at 1:52 PM#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: Jan 9, 2025 at 3:52 PM
8 11Dr.PathRoch, mona_PHX, andrew_nyc and 5 others
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SkepticalSean
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Jan 9, 2025 at 6:10 PM#10
BariatricNurseD said:
The dose-response is real but shallow at the top.

All true, with one condition: that curve is for people who reached the dose on schedule. Anyone who slowed the ladder for tolerability is on a different, flatter curve, and comparing yourself with the published mean will make you feel like a non-responder when you are not.

38 11Dr.LipidDallas, alex_tucson, kevin_tulsa and 35 others
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