Retatrutide, a Triple Hormone Receptor Agonist, for Treatment of Obesity

• p. 2 Introduction, first paragraph

  cardiovascular disease17,18

• p. 13 Reference 18

  rationale and design of the SURMOUNT-

Only the authors can say what is right here.

Judge's note: The page 2 image shows the superscript 17,18 after "cardiovascular disease". The reference list on page 13 gives entry 18 as a rationale-and-design paper by its own title, which would not report outcome results. Reference 17 (the semaglutide cardiovascular outcomes trial) does fit the sentence. Whether a different citation was intended is for the authors to say.

Second check: another model agreed

• p. 3 End Points and Assessments

  Other evaluations included the physical-function

• p. 9 Table 2 (under 'Key secondary end points in the overall population')

  Change in composite physical function score on IWQOL-Lite-

Only the authors can say what is right here.

Judge's note: Page 3 image: the sentence follows the list of key secondary end points, opens with "Other evaluations" and names only the 9-mg and 12-mg doses. Page 9 image: the IWQOL-Lite-CT rows sit under the key-secondary heading with 4-mg values, and the table footnote says differences were significant for all primary and key secondary end points. The article does not say whether these scores, and the 4-mg comparison, were controlled for type I error. The statistical details are deferred to the Supplementary Appendix, which is not among the files.

Second check: another model agreed

• p. 4 Results, Participants, second paragraph

  and in 11.1% of

• p. 11 Table 3, Leading to discontinuation of retatrutide or placebo, 12 mg

  65 (11.2)

• p. 11 Table 3 footnote ‡

  The denominator for these values is not the safety population but the randomly assigned population.

• p. 4 Participants

  in 11.1% of those receiving the 12-mg dose

Judge's note: Read on the page 4 and page 11 images. With the randomised denominator that footnote ‡ declares, 65/584 is 11.13%, which matches the text's 11.1. The table's 11.2 matches the safety denominator instead (65/582 is 11.17%). The other cells in the row fit the randomised denominators (4.1, 6.5, 4.6). The discrepancy is 0.1 percentage point, so it is rated minor.

Second check: another model agreed

• p. 12 Discussion, first paragraph on page

  resulted in a mean weight reduction of 19% and

• p. 8 Table 2, percent change in body weight, 4 mg

  −17.6 (−18.6 to −16.7)

• p. 4 Body-Weight Outcomes

  of less than 30 was met in 40.1 to 57.1% of the

• p. 4 Results, Body-Weight Outcomes (efficacy estimand)

  the efficacy-estimand calculation were −19.0%,

Only the authors can say what is right here.

Judge's note: Sentence read on the page 12 image. The Results on page 4 give the 4-mg change as −17.6% (treatment-regimen) and −19.0% (efficacy). Figure 1B gives BMI <30 for 4 mg as 40.1% under the treatment-regimen estimand. So the unlabelled 19% matches the efficacy estimand, while "more than 40%" matches the treatment-regimen value. It could also be an efficacy-estimand value, but that figure is in the supplement, which is not among the files. Elsewhere the Discussion labels each number with its estimand. This is an unlabelled, possibly mixed, estimand rather than a wrong number.

Second check: another model agreed

• p. 5 Body-weight outcomes, extension-phase paragraph

  placebo was −18.9%, −25.7%, −28.7%, and −29.9%,

• p. 8 Table 2, Extension phase, percent change at 104 wk

  −18.9 (−20.4 to −17.4)

Only the authors can say what is right here.

Judge's note: Page 5 image confirms the sentence. Table 2 (page 8) shows that −18.9 is the placebo-to-retatrutide group and that −25.7, −28.7 and −29.9 are the original 4-mg, 9-mg and 12-mg groups. The numbers agree with the table; the sentence misattributes them all to the group that switched from placebo. The wording needs the authors' revision.

Second check: another model agreed

• p. 10 Discussion

  diastolic blood pressure, triglycerides, low-density lipoprotein cholesterol

• p. 9 Table 2

  Percent change in non-HDL cholesterol (95% CI)

Judge's note: Read the Discussion on the page 10 image and the Results and Table 2 in the text layer. The Results list waist circumference, systolic blood pressure, fasting insulin, hsCRP, triglycerides and non-HDL cholesterol. LDL does appear in Figure 2A (−13.2, −18.7, −16.3 vs −4.7), marked as not controlled for type I error, so the LDL part is supported. Diastolic blood pressure appears only in the Introduction, describing the phase 2 trial. The Results sentence also points to Figs. S15 to S19 and Table S7, which are not among the files and may hold the diastolic data, so this is a minor consistency point only.

Second check: another model agreed

• p. 2 Methods, Trial Design

  double-blind, trial

Judge's note: The comma is visible in the page 2 image. The abstract has the correct form, "randomized, double-blind trial".

Second check: none (judge only)

• p. 3 End Points and Assessments, third paragraph

  weight-reduction thresholds of 5% or more or

• p. 3 End Points and Assessments, second paragraph

  weight-reduction thresholds of 5% or more to

Judge's note: Both sentences are on the page 3 image. "In 5% increments" needs a range, and the earlier parallel sentence uses "to", so the second "or" should be "to".

Second check: none (judge only)

• p. 3 End points

  Quality of Life Lite–Clinical Trials version

• p. 5 Table 1 footnote ‖

  Quality of Life–Lite Clinical Trials

Judge's note: Both forms are visible on the page 3 and page 5 images. The dash sits in a different place and "version" appears only in the Methods. This is a cosmetic inconsistency. The Methods form also puts the abbreviation in square brackets with no enclosing parentheses.

Second check: none (judge only)

• p. 7 Safety, first line of page

  groups and in 5.5% of those in the placebo

• p. 7 Safety, serious adverse events

  in 5.5% of those in the placebo groups

• p. 7

  5.5% of those in the placebo groups (Table 3)

Judge's note: Page 7 image, first lines, shows "placebo groups". The trial has one placebo group; the same paragraph and Table 3 use "placebo group". Copy-editing slip.

Second check: none (judge only)

• p. 8 Table 2, percent change in body weight, placebo

  −3.9 (−4.9 −3.0)

• p. 8 Table 2, WOMAC difference vs. placebo, 9 mg

  −1.6 (−2.2 −1.0)

• p. 9 Table 2, triglycerides, 4 mg

  −30.9 (−33.1 −28.6)

• p. 9 Table 2, triglycerides, 9 mg

  −36.4 (−38.6 −34.2)

Judge's note: All five are visible on the upright page images: on page 8, placebo percent change in body weight and the 9-mg WOMAC difference; on page 9, triglycerides at 4 mg and 9 mg and placebo non-HDL cholesterol. Every other interval in the table uses "to". It is not an extraction artefact. Cosmetic; the values are not in question.

Second check: code check

• p. 9 Table 2, percent change in fasting insulin

  −43.10 (−45.96 to −40.10)

Judge's note: Seen on the page 9 upright image: all four columns of the fasting insulin row use two decimals, and the rest of the table uses one. It is a presentation inconsistency only and may be deliberate; no value is in question.

Second check: none (judge only)

• p. 10 Figure 2 legend

  data- points set

Judge's note: On the page 10 image the phrase falls in the middle of a legend line, not at a line break, and shows a gap after the hyphen. The Table 2 footnote prints "data-points set" and the Figure 1 legend "data-point set". Cosmetic.

Second check: none (judge only)

• p. 12 Discussion

  Ten adjudicated-confirmed pancreatitis events

• p. 11 Table 3

  Adjudication-confirmed pancreatitis

Judge's note: Page 12 image shows "Ten adjudicated-confirmed pancreatitis events". Table 3 on the page 11 image has "Adjudication-confirmed pancreatitis", and the page 7 text has "adjudication-confirmed major adverse cardiovascular event". This is a cosmetic wording inconsistency. The count itself agrees with Table 3 (1+3+4+2 = 10).

Second check: none (judge only)