GoggleDocs

💉 Once-weekly basal insulin is here. MHRA has authorised Onswik (efsitora) for #T2D

🏛️NICE: an option, but use the least expensive suitable basal, NPH included. Likely role: people who need help to inject.

UK price confidential. Awaiting final TA + ICB pathways.

🔗gov.uk/government/new…

🔗frontiersin.org/journals/endoc…

🚨Retatrutide TRIUMPH-1 (NEJM)

80 wk weight: ⤵️25% on 12 mg vs -3.9% placebo.
⤵️28.3% headline = efficacy estimand.

👉9 vs 12 mg near identical; only 54% still on 12 mg at wk 80
⚠️⚡️Dysaesthesia, hypotension, MACE 9 v 1 (small n)

Treat to target, not max dose❓

🔗 nejm.org/doi/full/10.10…

🚨#Tirzepatide and AF: signal or noise? 🫀

🆕 JAHA meta-analysis (10 RCTs, n=6,515): AF OR 2.20 (0.81–6.75), any arrhythmia OR 1.84 (1.04–3.90)

🔹Only 38 AF events, mostly from SUMMIT

🔸Semaglutide: 541 events, OR 0.83 (0.70–0.98)

👉Different class, different signal❓

🔗ahajournals.org/doi/10.1161/JA…
🔗academic.oup.com/eurjpc/advance…

#ESCcongress2025

💊 STAREE in NEJM: atorvastatin 40mg vs placebo, 9,971 adults aged 70+, 5.9 yrs

📉 Major CV events HR 0.70 ✅ NNT 37
⚖️ Disability-free survival HR 0.94 (0.84–1.05) ❌
📊 CV death HR 1.00

Fewer heart attacks. Not a longer or more independent life

💊 The 82-year-old on a statin since their 60s. No ASCVD, no symptoms, no evidence either way

SAGA/SITE finally randomised it 🔬

📊 3-yr mortality 7.9% continue vs 7.2% stop
✅ Non-inferior (−0.68%, CI −3.95 to 2.60)
❗ No QoL gain from stopping

Shared decision, not a rule

🔗thelancet.com/journals/lanhl…