SURMOUNT-4's randomised withdrawal design is the strongest available evidence about what happens on stopping. It says nothing about a lower maintenance dose, because the comparison was continue versus placebo rather than continue versus less. That is all I can say without guessing.
SURMOUNT-4 and what withdrawal data does and does not tell an individual — setting out what I have, and where I think it stops being reliable.
I would like to disagree carefully with the settled view on SURMOUNT-4, and I would like to be argued out of it if the disagreement is bad.
The disagreement is about one step, not about the conclusion. If the step holds I withdraw it entirely.
SURMOUNT-4's randomised withdrawal design is the strongest available evidence about what happens on stopping. It says nothing about a lower maintenance dose, because the comparison was continue versus placebo rather than continue versus less.
That is all I can say without guessing.
Gastrointestinal effects were comparable in character to the GLP-1 monoagonists across the programme. Individual reports here vary in both directions, which is what you would expect from a between-person difference rather than a between-drug one.
I would rather say I do not know than round it up to an answer.
Taking post #3 at face value and following it one step further.
Nausea profile: some people report tirzepatide as less nausea-prone than semaglutide, others report it as more. The trial reported gastrointestinal effects broadly comparable in character. Individual variation is the largest factor.
The conclusion is tentative; the arithmetic underneath it is not.
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4 | 8.4k | 7mo | |
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+17 | 21 | 17k | 12d |
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+3 | 7 | 33k | 13h |
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3 | 11k | 9h | |
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+26 | 30 | 5.8k | 23h |
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+5 | 9 | 21k | 7mo |
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