amsterdam_pete said:The gap between trial results and real-world results is consistent and it is not fraud.
I read this differently from amsterdam_pete, on substance rather than tone. Two drugs, two side-effect profiles, one price. The efficiency argument only works if the tolerability really is better than dose-escalating a single agent, and I have not seen that demonstrated head to head.
Adding the numbers, since they settle part of this. 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.
Ask again with the specifics and you will get a better answer than this one.
KevinCompounds said:Two drugs, two side-effect profiles, one price.
Coming at KevinCompounds’s question from a different direction. 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.
Correct me if the detail matters more than I have assumed.
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View ResultsOne thing that is still open after ingrid_STO’s answer:
How to read a result like this without either dismissing it or over-reading it, since the summaries all read like press releases?
Closing the loop on my own question.
Update — my curve sits below the published mean and the explanation is that the trial arm had support I do not have. That was reassuring rather than otherwise.