TrialTracker_MD said:

The gap between trial results and real-world results is consistent and it is not fraud.

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.

That is the short version; the long version is somebody else's post.

fiona_glasgow said:

Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.

Thank you for spelling out the reasoning rather than just the conclusion.

TrialTracker_MD said:

The gap between trial results and real-world results is consistent and it is not fraud.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. 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.

The figures, for anyone assembling their own picture. A quick sanity check on any figure quoted here: is it mean or median, is it intention-to-treat or completers, and what was the comparator. Three questions, and they resolve most disagreements in these threads.

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part. Carry on.