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Why do two papers on TRIUMPH-3 report different headline figures?

Asked 22 Feb 2026Modified 2 months agoViewed 9.2k times
26

My laboratory results are from the same laboratory each time, drawn fasting, which I gather matters.

I keep seeing this stated as a fact with no explanation attached, and unexplained facts make me suspicious.

My background is quantitative but not chemical, so I can follow an equation more easily than a hand-wave.

Is the standard explanation correct, and if so, what is the evidence for it?

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askeda_lindgren58k24822 Feb 2026
2Can you link the publication rather than the summary? The summary usually drops the interval. – e_dziedzic 4 months ago
3Is this the randomised phase or the open-label extension? – priya_menon 5 months ago
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2 Answers

Accepted answer first, then by votes
79

Accepted answer

Because two papers on TRIUMPH-3 are usually reporting two different estimands from the same randomisation. The treatment-policy estimand asks what happened to everyone assigned, including those who stopped; the trial-product estimand asks what happens if you keep taking it. The second is always the larger number, and both are legitimate answers to different questions. Then there is the analysis population — randomised, treated, or completers — and the handling of missing data, where a last-observation-carried-forward and a multiple imputation can differ by a point or more. Neither paper is wrong. Read the statistical methods section and you will find both figures defined in it.

The relevant detail is that the trial answers a narrower question than the headline suggests, and the narrowing is where the useful information is.

A composite endpoint is only as informative as its least serious component. Where a cardiovascular composite combines death, infarction and stroke, ask which component moved, because they are not interchangeable outcomes.

The underlying point is that intention-to-treat and per-protocol analyses answer different questions. ITT asks what happens if you offer the treatment; per-protocol asks what happens if it is taken as directed. The gap between the two is a measure of how tolerable the protocol was.

Where a result is quoted from a conference abstract rather than a peer-reviewed publication, the numbers routinely move between the two. It is worth checking which one you are reading.

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

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answered · acceptedDr_Ilse_Vandenberg113k24821 May 2026
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A trial establishes what happened to a defined group under a defined protocol. Extending it beyond that group is inference, and inference is allowed as long as it is labelled.

Placebo arms in this class are not nothing. Lifestyle-intervention placebo arms in the major obesity trials commonly lose two to three per cent of body weight, so an active-arm figure quoted without its comparator overstates the drug effect by roughly that much.

The relevant detail is that trial populations are selected. Exclusion criteria in this class routinely remove people with significant renal impairment, prior pancreatitis and unstable psychiatric illness, which is exactly the population the results are then quoted for.

Quote the interval alongside the estimate and half the disagreements on this site would not start.

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answeredtenth_of_a_unit57k371 Jun 2026
8Minor: the trial name is hyphenated in the original publication. – Dr_Colm_Fitzhenry 32 days ago
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Your answer

Ask PeptideStack is a static archive. Posting is closed, but the norms are worth stating: answer the question that was asked, show your working, cite the trial or the certificate, and say plainly where the evidence runs out.

Not medical advice. Research-use-only compounds are not approved for human use.