What does TRIUMPH-3 report at the 4 mg dose level?

Accepted answer

Read the 4 mg row, not the pooled one. A programme that randomised more than one dose level reports each arm separately, and the figure that circulates afterwards is usually either the top-dose arm or an average across arms nobody was randomised to. If TRIUMPH-3 ran a 4 mg arm, that row carries its own sample size and its own confidence interval, and both are narrower than the trial-level ones by roughly the square root of however many arms there were. Take the primary publication rather than the press release: one reports by arm, the other reports whichever number is largest. A dose level inside a trial is a protocol decision made under supervision, not a recommendation, and nothing here is medical advice.

Answer first: read the primary endpoint, the comparator and the population before you read the effect size. Almost every argument on this site about a trial is really an argument about one of those three.

Duration decides what can be seen. A 68-week trial can measure weight and glycaemia; it cannot measure anything whose event rate is one per cent per year without enrolling tens of thousands.

In practice, open-label extensions are not the same evidence as the randomised phase. Once everyone knows what they are taking, the reported outcomes acquire a bias that no analysis fully removes.

The cardiovascular outcome programme in this class runs to several large randomised trials — LEADER for liraglutide, SUSTAIN-6 and SELECT for semaglutide, REWIND for dulaglutide — and they are the reason the class is discussed as more than a weight intervention.

If a claim cannot be traced to a named trial with a named endpoint, treat it as a claim rather than as evidence.

edited 22 Jun 2026 by Dr_Colm_Fitzhenry — corrected a unit error in the worked example