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.
Worth separating that from the trial evidence, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.
I would rather be corrected than agreed with, if it comes to it.
One thing that is still open after VendorMark’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?
stefan_berlin said: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.
Adding the part of the answer the thread has not reached. Relative and absolute effects need reading together. A 20% relative reduction on a high baseline risk is a large absolute benefit; the same relative figure on a low baseline risk is a small one, and press summaries almost always quote the relative number because it is bigger.
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Follow-up: I read the paper rather than the summary and the qualifier I was missing was in the second paragraph of the results.
sarah_TO said:Relative and absolute effects need reading together.
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.