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Compounds · Semaglutide

Why semaglutide's albumin binding is the whole reason weekly dosing works

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Solved by y.rahimi in post #3
The STEP programme populations were selected: enrollment criteria required baseline body mass index over 30, no recent blood pressure crisis, no recent retinopathy, no renal disease at the time. Applying results from that population to someone well outside it is an extrapolation and should be called one.

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MM
m.mwangiTL2 Moderator17 Jun 2025#1

Asking directly, because I could not find a straight answer: Why semaglutide's albumin binding is the whole reason weekly dosing works

Session topic: SELECT (N Engl J Med, 2023). Please read it before posting; the discussion is much better when everyone has.

The question I would like us to start with is what the trial set out to estimate, rather than what it found. Once that is on the table we can talk about whether the design could have answered it, and only then about the numbers.

Specific things I would like covered: the population and how far it generalises, how discontinuation was handled, whether the comparator was a fair one, and what the absolute rather than relative effect looks like.

I will summarise at the end and the summary will feed the relevant digest page.

1 like 13mo
LI
l.ibarraTL2Regular15 Nov 2025#2

I read the opening post twice before replying, because I had assumed the opposite.

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

5 likes 8mo
YR
y.rahimiTL2 Moderator Solution4 Mar 2026#3
l.ibarra, post #2: I read the opening post twice before replying, because I had assumed the opposite. Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing. The correction was fair and I had been repeating something I had not checked carefully enough. Go to post

The STEP programme populations were selected: enrollment criteria required baseline body mass index over 30, no recent blood pressure crisis, no recent retinopathy, no renal disease at the time. Applying results from that population to someone well outside it is an extrapolation and should be called one.

14 likes in reply to #2 5mo
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