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ForumsPublic SquareSELECT trial 4-year follow-up data released — sustained MACE reduction

SELECT trial 4-year follow-up data released — sustained MACE reduction

Dr.CardioMD Fri, Mar 13, 2026 at 11:48 AM 16 replies 240 viewsPage 1 of 4
Dr.CardioMD
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Mar 13, 2026 at 1:13 PM#1

SELECT trial 4-year follow-up data released — sustained MACE reduction

Posting this for discussion as it's directly relevant to our public square community. I'll summarize the key findings and then share my interpretation.

Background: SELECT trial 4-year data released sustained has been a topic of significant interest. The latest data adds substantially to our understanding of the efficacy and safety profile in this area.

Key findings:

  • Primary endpoint met with statistical significance (p<0.001)
  • Effect size consistent with or exceeding Phase 2 projections
  • Adverse event profile in line with the known GLP-1 receptor agonist class effects — primarily GI (nausea 20-25%, diarrhea 12-17%)
  • Subgroup analyses showed benefit across BMI categories, age groups, and baseline metabolic status

My interpretation:

This is meaningful for several reasons. First, it confirms that the results from earlier-phase trials are reproducible at scale. Second, the safety data with longer follow-up is reassuring. Third, the subgroup consistency suggests this isn't driven by a specific patient phenotype.

I'd love to hear from others — especially those with clinical or research backgrounds. What are the limitations you see? What questions remain unanswered?

References:
[1] See thread title for study identification. Full citation available via PubMed/ClinicalTrials.gov.
— Dr.CardioMD | Posted in Public Square
36 14kim_atl_prep, sarah_TO, wendy_avl and 33 others
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andrew_nyc
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Mar 13, 2026 at 1:30 PM#2

Clinical perspective on SELECT trial 4-year data released :

I have managed over 200 patients on GLP-1 therapy and this topic comes up frequently. What the data shows — and what I see in practice — is that proper titration prevents most adverse events.

For this specific question, I would recommend: reviewing the relevant clinical guidelines.

30 19Dr.NateNeph, PharmD_Rodriguez, julia.endo and 27 others
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Dr.BariatricHTX
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Mar 13, 2026 at 1:47 PM#3
andrew_nyc said:
What the data shows — and what I see in practice — is that proper titration prevents most adverse ev

This is exactly right. andrew_nyc articulated what I have been trying to explain to my friends for months. The SELECT trial 4-year data aspect is what made the difference for me.

Last edited: Mar 13, 2026 at 7:47 PM
28 15Dr.EM_Chicago, pete_RVA, CarlaRPh_TPA and 25 others
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DataDave
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Mar 13, 2026 at 2:04 PM#4

Relevant to SELECT trial 4-year data — here is my latest bloodwork comparison:

Key improvements: A1C 8.0% → 5.3%, triglycerides 247 → 117 mg/dL, hsCRP 6.0 → 1.1 mg/L. All on tirzepatide for 15 months.

The inflammatory marker drop is what impresses me most. Consistent with the SELECT trial's cardiovascular findings.

24 16amsterdam_pete, LondonLisa, mike_nyc and 21 others
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LipidDoc_ATL
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Mar 13, 2026 at 2:21 PM#5
andrew_nyc said:
What the data shows — and what I see in practice — is that proper titration prevents most adverse ev

I respect andrew_nyc perspective but I think this oversimplifies things a bit. Re: SELECT trial 4-year data — the subgroup analyses show meaningful heterogeneity.

I am not saying andrew_nyc wrong entirely — just that the picture is more nuanced than a blanket statement. The SURMOUNT data specifically shows baseline BMI-dependent responses.

47 14KristenIndy, MarkLI_maint, Dr.PeteFamMed and 44 others
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