BiostatsBrad said:Worth knowing that the injection site changes very little.
Senior perspective on cardiovascular risk: I'm 70 years old and started this journey skeptically. My cardiologist recommended it after years of failed interventions.
14 months later: down 48 lbs, more mobile, pain reduced, medications simplified. My quality of life has improved dramatically. I wish this existed 20 years ago.
To other older adults hesitating: the SELECT trial proved benefit in our age group. You deserve to feel good in your body regardless of age.
BiostatsBrad said:Worth knowing that the injection site changes very little.
I want to bring up the cardiovascular angle on cardiovascular risk.
The SELECT trial demonstrated a 20% reduction in MACE with semaglutide 2.4mg[1]. This is practice-changing because the CV benefit appears to be independent of the degree of weight loss — suggesting direct vascular and anti-inflammatory mechanisms.
For cardiovascular risk, this means we need to think beyond the primary outcome and consider the cardiovascular implications. The all-cause mortality reduction (HR 0.81) is the most clinically meaningful signal.
[1] Lincoff AM, et al. N Engl J Med. 2023;389(24):2221-2232.
BiostatsBrad said:Worth knowing that the injection site changes very little.
Saving this. It is the first explanation that did not require me to already understand it. Taking it to my next appointment.
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View ResultsAdding the clinical framing, because it changes how the question reads.
SUSTAIN-6 was the first CVOT to show cardiovascular benefit with semaglutide, relevant to cardiovascular risk. In 3,297 T2DM patients with high CV risk: MACE HR 0.74 (95% CI 0.58-0.95, p=0.02)[1].
Notable: the retinopathy signal in SUSTAIN-6 (HR 1.76) was subsequently attributed to rapid A1C reduction in patients with pre-existing retinopathy — not a direct drug effect. This has been confirmed in longer-term follow-up studies.
[1] Marso SP, et al. N Engl J Med. 2016;375(19):1834-1844.
OP back with an update, since a thread like this is useless without one.
Update since I posted: I held at 1.7mg for a further twelve weeks and lost another 4kg slowly, which settles it for me. I was escalating because the number was available, not because I had stopped responding.