3 ms·

It drives me nuts when these things say stuff like "doubles your risk" w/o giving the original risk. Risk doubling from 5% to 10% is not in the same universe as

It drives me nuts when these things say stuff like "doubles your risk" w/o giving the original risk. Risk doubling from 5% to 10% is not in the same universe as risk doubling from .02% to .04%, which I believe is the actual risk in this case.

akira2501 2y ago
In terms of outcome, it maybe a tolerable risk, but anything that flat out doubles the risk ratio is fairly concerning; in particular, where the mechanisms are not well understood.
- yen223 2y ago
  When the numbers were small to begin with, a doubled risk ratio could just be the result of statistical noise. You are right in that the mechanisms may not be well-understood. This does warrant further study, as the paper concludes.
  - whimsicalism 2y ago
    the studies obviously adjusted for variance when considering if their conclusions are significant, you're beating up a strawman
- operator-name 2y ago
  All medications increases the risks of side effects, but they are prescribed because the benifits outweigh the downsides - even if little is known about their mechanism.
  - akira2501 2y ago
    > but they are prescribed because the benifits outweigh the downsides Some are. Some are simply prescribed because the patient asks for them. > even if little is known about their mechanism. I wouldn't take it unless my condition was immediately life threatening and there were no other medications available. There are very few classes of treatment that fall within these parameters.
- himinlomax 2y ago
  I'd happily double my risk of being hit by a meteorite for $10000.
  - akira2501 2y ago
    0.02% relative risk increase implies 2 in 10,000 will end up with the condition where they would not otherwise. Your chances of being hit by a meteorite are _at most_ 1 in 1,000,000. My happiness would not extend across several orders of magnitude like that, but perhaps, some people just need the $10k more than I would.
operator-name 2y ago
It's really frustrating because both papers clearly lays out the numbers in natural frequencies: > During 1,915,120 person-years of observation, 218 persons developed NAION. Semaglutide 51 exposure associated with a higher incidence rate (0·228 vs 0·093 per 1000 person-years, p<0·001) 52 and independently predicted a higher risk of upcoming NAION (HR 2·19, 95% confidence interval 53 1·54-3·12), even when multiple other factors were taken into account. > In this cohort study conducted in Denmark and Norway, use of semaglutide was associated with an increased risk of NAION; the pooled hazard ratio was 2.81 (95% confidence interval (CI) 1.67 to 4.75) and the incidence rate difference (absolute risk increase) was +1.41 (95% CI +0.53 to +2.29) NAION events per 10,000 person-years. The finding was consistent across sensitivity and supplementary analysis.
- operator-name 2y ago
  Ah, hidden right at the end inside the "about the studies": > Both Danish studies show that the risk of developing NAION for the individual patient receiving treatment with Ozempic is only 0.2 per thousand per year, which is fortunately significantly lower than in the American study. NAION is a relatively rare condition, and the extra risk is therefore low. The researchers estimate that for every 10,000 people treated in a year, between 1.5 and 2.5 extra cases will be seen. Sadly it's still relative, and they still leave you the mental maths to work out the natural frequencies.

akira2501 2y ago

In terms of outcome, it maybe a tolerable risk, but anything that flat out doubles the risk ratio is fairly concerning; in particular, where the mechanisms are not well understood.

yen223 2y ago
When the numbers were small to begin with, a doubled risk ratio could just be the result of statistical noise. You are right in that the mechanisms may not be well-understood. This does warrant further study, as the paper concludes.
- whimsicalism 2y ago
  the studies obviously adjusted for variance when considering if their conclusions are significant, you're beating up a strawman
operator-name 2y ago
All medications increases the risks of side effects, but they are prescribed because the benifits outweigh the downsides - even if little is known about their mechanism.
- akira2501 2y ago
  > but they are prescribed because the benifits outweigh the downsides Some are. Some are simply prescribed because the patient asks for them. > even if little is known about their mechanism. I wouldn't take it unless my condition was immediately life threatening and there were no other medications available. There are very few classes of treatment that fall within these parameters.
himinlomax 2y ago
I'd happily double my risk of being hit by a meteorite for $10000.
- akira2501 2y ago
  0.02% relative risk increase implies 2 in 10,000 will end up with the condition where they would not otherwise. Your chances of being hit by a meteorite are _at most_ 1 in 1,000,000. My happiness would not extend across several orders of magnitude like that, but perhaps, some people just need the $10k more than I would.

operator-name 2y ago

It's really frustrating because both papers clearly lays out the numbers in natural frequencies: > During 1,915,120 person-years of observation, 218 persons developed NAION. Semaglutide 51 exposure associated with a higher incidence rate (0·228 vs 0·093 per 1000 person-years, p<0·001) 52 and independently predicted a higher risk of upcoming NAION (HR 2·19, 95% confidence interval 53 1·54-3·12), even when multiple other factors were taken into account. > In this cohort study conducted in Denmark and Norway, use of semaglutide was associated with an increased risk of NAION; the pooled hazard ratio was 2.81 (95% confidence interval (CI) 1.67 to 4.75) and the incidence rate difference (absolute risk increase) was +1.41 (95% CI +0.53 to +2.29) NAION events per 10,000 person-years. The finding was consistent across sensitivity and supplementary analysis.

operator-name 2y ago
Ah, hidden right at the end inside the "about the studies": > Both Danish studies show that the risk of developing NAION for the individual patient receiving treatment with Ozempic is only 0.2 per thousand per year, which is fortunately significantly lower than in the American study. NAION is a relatively rare condition, and the extra risk is therefore low. The researchers estimate that for every 10,000 people treated in a year, between 1.5 and 2.5 extra cases will be seen. Sadly it's still relative, and they still leave you the mental maths to work out the natural frequencies.