Accepted answer
Take it from the TRIUMPH-1 adverse-event table by arm, and check the unit before you use it. An incidence can be the proportion of participants who reported the event at least once, or the count of events divided by exposure time, and the two differ by however many people had it repeatedly. Then subtract the placebo arm, because the untreated rate is not zero. And read the discontinuation column beside it: an event that made people leave the trial is under-counted at every later visit, so a low late-timepoint incidence can mean the event was severe rather than rare.
Start with which symptom predominates, because the management diverges sharply even though the mechanism does not.
Fat is the macronutrient that slows emptying most on its own, so a high-fat meal on top of pharmacologically delayed emptying is the combination that produces the worst episodes.
Gastrointestinal adverse events, indicative pooled rates
| Event | Active arm | Placebo arm | Timing |
|---|
| Nausea | 40–45 % | 15–20 % | Peaks 1–2 wk after each step |
| Vomiting | 15–25 % | 5–8 % | Follows nausea |
| Diarrhoea | 20–30 % | 10–15 % | Early, variable |
| Constipation | 20–25 % | 8–12 % | Later onset, persistent |
| Discontinuation for GI events | 4–7 % | 1–2 % | Mostly during escalation |
Ranges span agents and doses; read the specific prescribing information for a specific figure.
The practical hierarchy of interventions: slow the titration, reduce meal size, reduce fat, separate fluids from meals, and only then consider symptomatic treatment.
Trial-reported incidence and discontinuation rates for gastrointestinal effects are published per agent and per dose and are the appropriate figures to quote.
Nothing here is medical advice.
Smaller meals, less fat, fluids between rather than with. In that order.
8The distinction between escalation-related and steady-state is the useful part. – lipid_panel_q 3 months ago Same experience here, different supplier. – h_pergande 5 months ago add a comment