Real-World GLP-1 Data: Vanderbilt Obesity Clinic Study (n=2,306)

[fatbegone]

"GLP1RA persistence and dosetitration adherence were moderate but weight loss approximated that seen in clinical trials, supporting real-world effectiveness."

Link to the study is in the link below 👇

Thread by @MichaelAlbertMD on Thread Reader App

@MichaelAlbertMD: 🚨 Real-World GLP-1 Data: Vanderbilt Obesity Clinic Study (n=2,306) Clinical trials showed 15–21% weight loss with semaglutide & tirzepatide. But how do patients actually fare in practice? - - - Key...…

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[slowsixstang]

13% of patients going to the ER for GI side effects is a crazy stat. Makes me wonder why.

 

[keangkong]

13% of patients going to the ER for GI side effects is a crazy stat. Makes me wonder why.

I fall within that 13%. When I got food poisoning while taking tirzepatide (which already caused GI side effects), I developed extreme diarrhea that came on suddenly. I became extremely dehydrated. I became too weak to stand. I called 9-1-1. When the paramedics arrived, they took my blood pressure, which was extremely low. They immediately hooked up a saline drip. They brought me to the ER. The doctors did not say that the GLP-1 drug caused this incident. But I had never been to the ER for diarrhea before. As a result, I attribute my ER visit to the combination of food poisoning and the GLP-1 drug.

 

[juGGaKNot]

13% of patients going to the ER for GI side effects is a crazy stat. Makes me wonder why.

Sema acid reflux/sulfur burps are pretty bad. I use to get the same ( before sema ) the day after eating more than 2kg of candy but with 2.4mg sema i would get that even if i only had sandwiches.

Any combination of fat and carbs. Went away when i switched to keto and also no problem on high carb low fat.

 

[desinr-gal]

13% of patients going to the ER for GI side effects is a crazy stat. Makes me wonder why.

The high dosage causes a lot of side effects in a percentage of people, who if they're not careful with hydration and digestive functions, could easily feel they require medical attention.
Since there are few open or urgent care clinics around anymore, heading to an ER is sometimes all you can do.

 

[MsGizmo]

13% of patients going to the ER for GI side effects is a crazy stat. Makes me wonder why.

If you look at the titration data you can see 13.5% are started out on 1mg or more of sema. That's 4 times higher than the recommended dose. Its even worse with Tirz where 48% are started out on 10mg or more ... again 4 times higher than recommended. So why is anyone surprised by the number of people ending up in the hospital. We are supposed to put our lives into the hands of doctors who can't even be bothered to read about the drugs they dole out.

 

[BooneDonk]

If you look at the titration data you can see 13.5% are started out on 1mg or more of sema. That's 4 times higher than the recommended dose. Its even worse with Tirz where 48% are started out on 10mg or more ... again 4 times higher than recommended. So why is anyone surprised by the number of people ending up in the hospital. We are supposed to put our lives into the hands of doctors who can't even be bothered to read about the drugs they dole out.

I think that’s in the design of the late stage trials. See how far dosing can be pushed. I’ve been wrong before though.

 

[MsGizmo]

I think that’s in the design of the late stage trials. See how far dosing can be pushed. I’ve been wrong before though.

It reads 1st RX, 2nd RX .. and so on. So to me, I think every column is 4 weeks. Also in the article that it links to it says:

"These patterns may reflect provider inexperience with established titration protocols, patient intolerance at higher doses, or supply chain constraints that limit access to maintenance regimens."

 

[slowsixstang]

I think that’s in the design of the late stage trials. See how far dosing can be pushed. I’ve been wrong before though.

This was my thought as well, but since this is real world data, it's very irresponsible of the prescribing doc to start someone at >10mg tirz or >1 mg sema.

 

[BooneDonk]

It reads 1st RX, 2nd RX .. and so on. So to me, I think every column is 4 weeks. Also in the article that it links to it says:

"These patterns may reflect provider inexperience with established titration protocols, patient intolerance at higher doses, or supply chain constraints that limit access to maintenance regimens."

This was my thought as well, but since this is real world data, it's very irresponsible of the prescribing doc to start someone at >10mg tirz or >1 mg sema.

I think we are all seeing/saying the same thing. I bet these folks did feel terrible at the mentioned doses and went to ER for sure!

 

[keangkong]

I think we are all seeing/saying the same thing. I bet these folks did feel terrible at the mentioned doses and went to ER for sure!

I had experienced constipation on GLP-1 drugs. But I had not yet experienced diarrhea. Then I got food poisoning while being on a GLP-1 drug. My diarrhea was extreme. I lost so much water that I was unable to stand. Although I didn't realize this until the EMS workers got there after I called 9-1-1, I had passed out, hitting my head on the toilet paper dispenser and breaking it. (My head was fine; I just experienced bruising.) I suspect there are people who did something stupid and as a result ended up in the ER. However not doing something stupid is not a guarantee you won't go to the ER while taking GLP-1 drugs. I have no regrets about taking the medication and while I have had some mild diarrhea, I've experienced nothing extreme since.