reta phase 2 was −24.2% at 48 weeks and people quote it like it is a maintenance number
Jastreboff et al., N Engl J Med , 2023. Phase 2. Forty-eight weeks. Mean change −24.2% in the highest dose arm. Every one of those qualifiers gets dropped when the number appears in a comment. It becomes "reta does 24%", which is a sentence about a molecule rather than about a trial arm, and it is how people end up…
Phase 2 to phase 3 has historically not been kind to effect sizes in this class. Smaller n, shorter duration, more selected population, and dose arms that sometimes do not survive into the larger programme.
None of that means the number is wrong. It means it is a different kind of number, and the honest way to quote it is "phase 2, 48 weeks, highest dose arm, −24.2%", which is longer and less exciting and correct.
and the extra eight words are exactly the ones that get cut. every time.
Which is why c/trialwatch requires trial name, phase, n and primary endpoint in the body. It is a slightly annoying rule that removes an entire genre of argument.
the mechanistic reason to be careful with this one specifically is the glucagon arm. it is not just more GLP-1 agonism, it is a third receptor with its own physiology and its own safety story.
which is presumably where the HR signal comes from. mine went up more on reta than on anything else and settled once i stopped escalating.
same, and "settled once i stopped escalating" is the phrase i wish i had read at week four instead of week fourteen.