Could obesity drugs help with alcohol cravings? New study suggests potential

There have been other preliminary reports that indicate similar findings for other kinds of addiction apart from tobacco and alcohol (like gambling), of course still to early to say the effect is real, or that it outweigh the risks from the treatment.

But this still could mean that there is some shared mechanism that could be addressed with a more specific drug even if there is no effect on weight reduction or diabetes.

Looking forward to what future randomized trials can prove about this, too bad that this is less likely to come from American universities now with the blocks in funding, so researchers in other countries (or pharmaceutical companies) will have to test this.

Gee, a drug that causes partial or complete paralysis of you gastrointestinal tract makes you drink less! Who woulda thunk it?

Gee, a drug that causes partial or complete paralysis of you gastrointestinal tract makes you drink less! Who woulda thunk it?

Without a relationship with this rare complication the criticism is baseless, there is no chance this specific group of patients had a 40% incidence of the problem to explain the very important effect observed.

Also, people do not smoke with their gastrointestinal tract either, so this hypothesis makes no sense.

Gee, a drug that causes partial or complete paralysis of you gastrointestinal tract makes you drink less! Who woulda thunk it?

Without a relationship with this rare complication

The complete paralysis is relatively rare, but the common feature of the drug is that it slows down the activity of the GI tract and food ferments as it moves slowly through it. That's why nausea, bloating and other unpleasant side effects are common.

So yeah, when you're feeling nauseous, bloated, fatigued, have abdominal pain or heartburn, you're less likely to do a bunch of things like drinking alcohol, smoking...

So yeah, when you're feeling nauseous, bloated, fatigued, have abdominal pain or heartburn, you're less likely to do a bunch of things like drinking alcohol, smoking...

Yes. Having experienced something like that after surgery at one time, I agree. The idea of drinking still appealed at the end of every day, but the actual act? A weird disconnect. Just stopped.

The complete paralysis is relatively rare, but the common feature of the drug is that it slows down the activity of the GI tract

To a point where it makes a difference for liquids? not at all.

So yeah, when you're feeling nauseous, bloated, fatigued, have abdominal pain or heartburn, you're less likely to do a bunch of things like drinking alcohol, smoking...

Again, that is not what happens except for a minority of patients, definetely not to 40% as you are trying to misrepresent. Trying to attribute a very common effect to some very uncommon reasons makes absolutely no sense. It also betrays a complete lack of knowledge about addictions, there have always been drugs that make alcohol consumption unpalatable, but the only thing that means is that the drugs are much more easily abandoned.

GLP-1 agonists effect against addiction work by other mechanisms.

https://www.npr.org/sections/health-shots/2023/08/28/1194526119/ozempic-wegovy-drinking-alcohol-cravings-semaglutide

Again, that is not what happens except for a minority of patients, definetely not to 40% as you are trying to misrepresent.

You keep bringing up that 40%. Does it come from this statement:

During the last weeks of the study, nearly 40% in the semaglutide group reported no heavy drinking days compared with 20% in the placebo group.

This was a very small study of 48 people over 2 months. Assuming they divided them up into two groups of 24: 19 people in the placebo group reported heavy drinking days, while 14 people in the drugged group reported heavy drinking days. That means that an extra 4 people out of 24 in the drugged group did not report heavy drinking days. That is well within the rates of feeling nausea. If you then add the other side effects ...

Above, should be extra 5 people, not 4 (out of 24)...

This was a very small study of 48 people over 2 months

Which is a perfectly valid reason to say there is need for bigger, more detailed studies, but not for making up reasons that would not explain the observed phenomenon as you do.

That is well within the rates of feeling nausea

To the point of explaining the results? definitely not, specially because the nausea is usually very limited in time and intensity and can be dealt with by avoiding heavy meals.

This is not the first report that indicates the same thing, and of course it is not the only group of people that are studying it (as the reference provided shows clearly) it is beyond credible to think the obvious reason you believe explains the observation has not been taken into account for people that deal with the patients professionally. The mechanisms involved are different from simple gastrointestinal symptoms.

I see, so that was where you got the 40%. Thank you...

That is well within the rates of feeling nausea

To the point of explaining the results?

Yes, very much so.

Yes, very much so.

Professional scientists have already discarded this very obvious factor, nameless people on the internet pretending that scientists of many different groups are unable to see the obvious are not really something that can be taken seriously. Specially when you are unable to even address the other much more likely correct explanations given in the references just because they contradict something you want to believe even when it is not remotely likely to be correct.

Yes, very much so.

Professional scientists have already discarded this very obvious factor,

How so? Nameless people on the internet pretending that scientists have proven things cannot be taken seriously, especially when they misrepresent percentages.

This was a very small study of 48 people over 2 months. Assuming they divided them up into two groups of 24: 19 people in the placebo group reported heavy drinking days, while 14 people in the drugged group reported heavy drinking days. That means that an extra [5] people out of 24 in the drugged group did not report heavy drinking days. That is well within the rates of feeling nausea. If you then add the other side effects ...

When explained in that way, it's not so impressive.

This will be even more effective if they're buying the medicines

How so? Nameless people on the internet pretending that scientists have proven things cannot be taken seriously, especially when they misrepresent percentages.

What is impossible to take seriously is to think something obvious could have been inexplicably ignored by several groups describing the same effect. Also, there is no misrepresentation done, the 40% that reported an observable effect is not something that could be explained by mild, short lived problems that present mostly at the beginning of a dosage, not at the end. It is not even remotely believable, is like pretending engineer that design solar panels forgot to consider that the panels would break the first time they are under the rain.

When explained in that way, it's not so impressive.

You only had to read the beginning of the article, where they dedicate the introduction to precisely describe the study as small, the dedicate quite a lot of it to say why this is a preliminary study and how more evidence is necessary. Of course it is also important that this is not the only study that reports this effect.

This will be even more effective if they're buying the medicines

More like the opposite, since they would be more likely to abandon the treatment.

Also, there is no misrepresentation done, the 40% that reported an observable effect

Where did you get the 40%? If it's from the text I quoted above, you certainly are misrepresenting it.

When explained in that way, it's not so impressive.

You only had to read the beginning of the article, where they dedicate the introduction to precisely describe the study as small, the dedicate quite a lot of it to say why this is a preliminary study and how more evidence is necessary. Of course it is also important that this is not the only study that reports this effect.

I doubt WP was mainly referring to the study being small, but rather to the actual percentages put in the proper perspective.

Where did you get the 40%? If it's from the text I quoted above, you certainly are misrepresenting it.

There is no misrepresentation, there is no credible way problems that are mild and quick to resolve would explain that 40% of the people have no heavy drinking days on the last week of the study, specially because the problems are observed at the beginning of dosage. It is not credible in any way.

I doubt WP was mainly referring to the study being small, but rather to the actual percentages put in the proper perspective.

Changing the percentages to other situations would be extremely clear, it is only the low number of participants what makes it necessary further studies to make strong conclusions.

For example, if 1000 people got sick of disease X, to 500 it is given a treatment, resulting in 200 surviving, meanwhile for the 500 untreated only 100 did, that would give the same percentages and it would be extremely strong evidence of effect.

It is a misrepresentation because it is not "40% that reported an observable effect".

No need to make up some stats to prove a point. Raw Beer described the data in a clearer, not deceptive, way.

Assuming they divided them up into two groups of 24: 19 people in the placebo group reported heavy drinking days, while 14 people in the drugged group reported heavy drinking days. That means that an extra [5] people out of 24 in the drugged group did not report heavy drinking days.

*5 out of 24 is NOT 40%.*

No need to make up some stats to prove a point. Raw Beer described the data in a clearer, not deceptive, way.

The percentage in the example are the same, it just makes it more obvious the effect is very important.

5 out of 24 is NOT 40%.

The extra people amount to a total of 40% where the effect was observed, there is nothing wrong with that.

Virus: American Universities blocking funding like UBC (Canada) or NAUM (Mexico) or do you or AI mean USAmerican Universities ?

Virus: American Universities blocking funding like UBC (Canada) or NAUM (Mexico) or do you or AI mean USAmerican Universities ?

I mean USA government blocking funding for universities by eliminating research-grant review meetings (no meetings means no grant are decided) and by imposing realistically impossible overhead percentages so no grant can be justified. The current situation means most if not all medical research will have to be suspended in the USA (or taken over by the industry that will publish only what is profitable).

This means that if something is found specifically useful to eliminate addiction related cravings it will be costly and limited, at least in the USA. Very likely as intended.

5 out of 24 is NOT 40%.

The extra people amount to a total of 40% where the effect was observed, there is nothing wrong with that.

Wrong again.

"... nearly 40% in the semaglutide group reported no heavy drinking days compared with 20% in the placebo group."

Assuming their results are valid, it is only about 20% (5/24) where the effect was observed.

Wrong again.

Why pretend this very simple fact is wrong when you yourself are saying the same.

The extra people amount to a total of 40% where the effect was observed

is the same as

nearly 40% in the semaglutide group reported no heavy drinking days

ssuming their results are valid, it is only about 20% (5/24) where the effect was observed.

That would be wrong, because that would make it the same as the negative group, where 20% has the observed effect. You are trying to misrepresent the total as the difference.

You can compare with the example I gave the percentages are the same but the higher numbers would be enough to identify this as a very effective therapeutic intervention.

Another valid way to say the same is that the drugs increased in a 100% the number of people where the desired effect was observed, it is all saying the same thing.

Why pretend this very simple fact is wrong when you yourself are saying the same.

The extra people amount to a total of 40% where the effect was observed

is the same as

nearly 40% in the semaglutide group reported no heavy drinking days

Well, thank you for confirming that that is where you got the 40% from. But I can't believe you actually believe what you're writing.

"... nearly 40% in the semaglutide group reported no heavy drinking days compared with 20% in the placebo group."

is clearly not the same as

"The extra people amount to a total of 40% where the effect was observed"

The determine the effect of the drug, you compare it to the placebo.

So according to you, if 40% of the placebo group also reported no heavy drinking days, then you you would still claim that the effect of the drug was observed in 40% of the drugged, even though there was no difference between the two groups.

 But I can't believe you actually believe what you're writing.

It was explained with very simple terms, the desired effect is what amounts to 40%, an increase of 20% over the effect observed on the negative control.

The determine the effect of the drug, you compare it to the placebo.

Then you can say it has a further 20% compared to placebo, but that does not change that 40% of the people drink less under the treatment, that is what is observed and (if confirmed) is what would be used to use the drugs for this purpose.

"Treatment with drug X allows 40% of the people to reduce their addictions" in the same way that saying "Treatment with antibiotic X allows for a 80% survival on patients with Y infection" Even if patients with Y infection survived 20% of the time without the antibiotic that would not make it valid to reduce the claim to 60%, that would make no sense.

So according to you, if 40% of the placebo group also reported no heavy drinking days, then you you would still claim that the effect of the drug was observed in 40% of the drugged, even though there was no difference between the two groups.

In that case the effect would be 40%, the same as placebo. The confusion you have is between observing the effect desired and observing an increase. In this case the increase is of 100% compared with placebo, in your example it would be 0%.

In that case the effect would be 40%, the same as placebo.

I see, so a drug that has no effect would still have a 40% effect. Got it! Just admit you were wrong, it's getting embarrassing...

"Treatment with drug X allows 40% of the people to reduce their addictions"

How do you know? Before the treatment, did all participants have at least one heavy drinking day each 9 weeks.

If that is the case, why would the "sham injection" (placebo) then cause a 20% reduction of their addiction?

I see, so a drug that has no effect would still have a 40% effect. Got it!

Placebo has an effect, that is the whole point of doing it.

Just admit you were wrong, it's getting embarrassing...

It has been terribly simple to demonstrate my point is correct and valid. The example that proved this was so clear that you had to ignore it because it demonstrate the point without problem.

How do you know? Before the treatment, did all participants have at least one heavy drinking day each 9 weeks.

This is as reported, which is what you can talk about. It makes no sense to just assume an arbitrary number.

Is as invalid as just assuming that without any intervention 18% of the people would have no heavy drinking days after the same time following, which would make the intervention have an effect (against no intervention of a 22% reduction while placebo would have a 2% effect, an increase of 1100%

If that is the case, why would the "sham injection" (placebo) then cause a 20% reduction of their addiction?

It is called the "Placebo effect" precisely because of this, people think they are being treated so they improve. It happens the same for lots of subjective things (pain, sleep disorders, etc.)

These obesity drugs have so many harmful side effects, so forget about the alcohol issue.

These obesity drugs have so many harmful side effects, so forget about the alcohol issue.

The benefits completely outweigh the risks for all the uses that have been approved, if it is confirmed that it can also treat alcohol addiction it would be perfectly logical to assume the same, after all alcohol consumption comes with many associated risks, both acute and chronic, so even some negative side effects would still be justified.

These obesity drugs have so many harmful side effects, so forget about the alcohol issue.

Yes, many have suffered terribly from them, including permanent GI paralysis and even death. Lately, there have also been reports of blindness.

And you have to treat about 5 people to get one person to not drink heavily for 9 weeks. Not worth the risk, there are safer options.

Also, interestingly, one of the authors (Klein) received consulting fees from Novo Nordiskand research related contracts from Bayer, Boehringer-Ingelheim, Carmot, Diasome, Eli Lilly, Novo Nordisk, Rhythm Pharmaceuticals, and vTv Therapeutics.

Yes, many have suffered terribly from them, including permanent GI paralysis and even death.

Not nearly as much as to put into question that they benefits obtained from the drugs greatly outweigh the risks. That is why the drugs are allowed to be used under medical supervision.

Every medical treatment produces "many" cases of problems including death, including supplements or excercise, but when the benefits from that intervention is much more important they are justified to be used.

And you have to treat about 5 people to get one person to not drink heavily for 9 weeks. Not worth the risk, there are safer options.

According to the results you get 2 people to show the desired results. For those that work against addictions that is a huge benefit, much more when you take into account the many other benefits from the drugs. That is why no medical professional association supports your claim that it would be "not worth the risk".

Also, interestingly, one of the authors (Klein) received consulting fees from Novo Nordiskand research related contracts from Bayer, Boehringer-Ingelheim, Carmot, Diasome, Eli Lilly, Novo Nordisk, Rhythm Pharmaceuticals, and vTv Therapeutics.

Which would explain why any observed problem with the methodology and results appear, but without those problems it is not relevant. It is as interesting that the rest of the authors didn't receive any fee.

The risks taken on in the hopes of lowering cravings for alcohol!!!

The risks taken on in the hopes of lowering cravings for alcohol!!!

Therefore lowering much more important risks produced by the consumption of alcohol, it is the same as in every other medical interventions, all have risks but those that are used have much more beneficial effects.

Yes, many have suffered terribly from them, including permanent GI paralysis and even death.

Not nearly as much as to put into question that they benefits obtained from the drugs greatly outweigh the risks.

No, they do not, and there are much safer (and cheaper) alternatives.

And you have to treat about 5 people to get one person to not drink heavily for 9 weeks. Not worth the risk, there are safer options.

According to the results you get 2 people to show the desired results.

No, compared to placebo, it's 5 out of 24 (about 1 out of 5). That is how effect is evaluated.

No, they do not, and there are much safer (and cheaper) alternatives.

The experts say they do and can present countless examples of scientific studies to prove it.

Nameless people on the internet say the experts are wrong, but present nothing to support that claim.

It is clear which side is correct here.

No, compared to placebo, it's 5 out of 24 (about 1 out of 5). That is how effect is evaluated.

That is still wrong, once again because you think the "placebo effect" produced no effect, which is transparently mistaken.

After the treatment 40% of the people had the desired effect, that means you get 2 out of 5 where it worked. Comparing to placebo do absolutely nothing to reduce the final percentage of people for whom the treatment worked.

The risks taken on in the hopes of lowering cravings for alcohol!!!

Yes, and it probably does that by simply making you feel nauseous. The percentage of people feeling nauseous with these drugs is equal to or greater than the 20% effect observed (compared to placebo). Add to that the other common side effects (feeling bloated, stomach pain, fatigue...), I not surprised people drink less.

When I got norovirus a few years ago, I didn't drink alcohol that day....

Yes, and it probably does that by simply making you feel nauseous.

No, not likely at all. In fact it has been refuted by other groups studying the same effect. This explanation you want to impose completely depends on professional medical scientists ignoring a very obvious explanation, which is impossible to believe. The simple fact that the effect is produced at the end of the treatment (where nausea and other side effects have already subsided) helps understanding how this explanation is not correct.

The link I provided shows how the experts thing this is explained by effects directly on the brain

https://www.npr.org/sections/health-shots/2023/08/28/1194526119/ozempic-wegovy-drinking-alcohol-cravings-semaglutide

No, compared to placebo, it's 5 out of 24 (about 1 out of 5). That is how effect is evaluated.

That is still wrong, once again because you think the "placebo effect" produced no effect, which is transparently mistaken.

No drugs are always compared to placebo. Think back to when they were testing vaccines. Imagine if they gave the shot to one group and a placebo to the other group, and 100% in both groups did not get an infection during the next 9 weeks. You can't claim that the vaccine is 100% effective!

And you're assuming that without any treatment at all, all patients would have had a heavy drinking day with the 9 weeks. What is the baseline?

No drugs are always compared to placebo

But what you are saying that the placebo effect should be substracted from the reported effects of the intervention, which makes absolutely no sense. Treating includes the placebo effect, so the full effect is what is reported.

This was proved clearly in the example I gave that you try very hard to ignore because it disproves this mistaken claim you like to make.

Think back to when they were testing vaccines. Imagine if they gave the shot to one group and a placebo to the other group, and 100% in both groups did not get an infection during the next 9 weeks. You can't claim that the vaccine is 100% effective!

Yes, the same as placebo. That (including both) is precise reporting.

Using your example:

https://pubmed.ncbi.nlm.nih.gov/8052818/

Around 85% of the children survive measles without vaccine, but after being vaccinated more than 99% survive. The efficacy of the measles vaccine is reported to be:?

Over 99%, not just over 14%

And you're assuming that without any treatment at all, all patients would have had a heavy drinking day with the 9 weeks. What is the baseline?

The same as before:

This is as reported, which is what you can talk about. It makes no sense to just assume an arbitrary number.

Is as invalid as just assuming that without any intervention 18% of the people would have no heavy drinking days after the same time following, which would make the intervention have an effect (against no intervention of a 22% reduction while placebo would have a 2% effect, an increase of 1100%

But what you are saying that the placebo effect should be substracted from the reported effects of the intervention, which makes absolutely no sense.

No, that is not what he is saying.

No, that is not what he is saying.

That is precisely what the text means, there is no other interpretation for thinking the effect of the treatment should be reported as 20% when the total actually is of 40%.

The easiest way of seeing this is that you are unable to argue or explain how this is not what is being said.

Around 85% of the children survive measles without vaccine, but after being vaccinated more than 99% survive. The efficacy of the measles vaccine is reported to be:?

Over 99%, not just over 14%

Assuming your quote is a real one (I don't want to pay to read the article):

Obviously not 14%. But from 100 measles infections, out of the 15 that normally would die, over 14 would survive if vaccinated. That is how you figure out effectiveness.

So if it was 90% survival without vax, but 70% survival with vax, you would say the vax is 70% effective? Of course not. You can't just take a percentage and use that number as the effect.

 if it was 90% survival without vax, but 70% survival with vax, you would say the vax is 70% effective? Of course not. You can't just take a percentage and use that number as the effect..

Yes you do, that is how the vaccines effects are reported

https://www.cdc.gov/vaccines/vpd/polio/hcp/effectiveness-duration-protection.html

Two doses of inactivated polio vaccine (IPV) are 90% effective or more against paralytic polio; three doses are 99% to 100% effective.

What do you think this 99 to 100% means? that unvaccinated children become paralytic 100% of the time but vaccinated this is reduced to 1 or 0% (so the 99-100 is the "difference")?

Obviously not, but this is still how the efficacy of the vaccine is reported and people understand that without problems.

For this treatment is the same, it is perfectly valid to say it is 40% effective at producing the effect reported. Saying otherwise is as incorrect as thinking there is no effect for the placebo effect.

You keep contradicting yourself with your own examples, pretending that an imaginary no difference or negative difference compared with placebo would mean the real life examples are false, they are not. The obvious explanation is that no superior effect or a negative effect compared with placebo only means the intervention is not used in the public, so there is no need to report something that is not used.

No, I'm using those examples to clearly illustrate how wrong it is to just take a percentage and use it as is without the proper context.

Except you never show it is wrong, and the clear real life example prove it is how the percentage is used as the effect of a medical intervention without any problem.

I'll just leave you with this, from a respected institute of medicine:

You understand that according to your own claim (total effect minus the effect of placebo) the vaccine efficacy would be 97.5% protection - 47.5% protection = 50% "efficacy", right?

Your own source says that your claim is wrong, mistaken.

The treatment shown in this study an effect on 40% of the patients, in the same way that the polio vaccine shows a protective effect against paralysis in 99-100% of the vaccinated people, there is nothing wrong with saying so.

The treatment shown in this study an effect on 40% of the patients

No, you say it's an "effect", that is where you are wrong. The authors of the above article and of the JAMA article do not consider it an effect.

40% is just the percent of people who did not have a heavy drinking day within the 9 weeks.

To get the effect of the semaglutide, you have to take into consideration the control (placebo).

No, you say it's an "effect", that is where you are wrong. The authors of the above article and of the JAMA article do not consider it an effect.

40% is just the percent of people who did not have a heavy drinking day within the 9 weeks.

And that is the effect observed from the treatment, it is quite simple. It is the same as the 99% protection from the polio vaccine, it is never necessary to "take into consideration" how many unvaccinated people are affected.

To get the effect of the semaglutide, you have to take into consideration the control (placebo).

That is your personal opinion, but not how the effect of treatment is reported generally, once again, pretending the placebo don't have any effect, even when it is called a placebo effect is where you are mistaken.

The treatment in this study showed effect in 40% of the people.

And that is the effect observed from the treatment, it is quite simple. It is the same as the 99% protection from the polio vaccine, it is never necessary to "take into consideration" how many unvaccinated people are affected.

Again, that's assuming that all members of an untreated would have had a heavy drinking day within the 9 weeks. That is not mentioned anywhere.

To get the effect of the semaglutide, you have to take into consideration the control (placebo).

That is your personal opinion,

No, it's the consensus of all the respected medical/scientific institutes of the world, such as cedars sinai. Not sure why my previous post was deleted but:

"we figure out efficacy with an easy formula: the risk in the unvaccinated group, minus the risk among the vaccinated, divided by the risk among unvaccinated."

https://www.cedars-sinai.org/blog/clearing-up-covid-19-vaccine-efficacy-confusion.html

Again, that's assuming that all members of an untreated would have had a heavy drinking day within the 9 weeks. That is not mentioned anywhere.

And again,

This is as reported, which is what you can talk about. It makes no sense to just assume an arbitrary number.

Is as invalid as just assuming that without any intervention 18% of the people would have no heavy drinking days after the same time following, which would make the intervention have an effect (against no intervention of a 22% reduction while placebo would have a 2% effect, an increase of 1100%

No, it's the consensus of all the respected medical/scientific institutes of the world, such as cedars sinai. Not sure why my previous post was deleted but:

One, the same problem still applies:

You understand that according to your own claim (total effect minus the effect of placebo) the vaccine efficacy would be 97.5% protection - 47.5% protection = 50% "efficacy", right?

Two, efficacy takes into account more than just the effect observed, that does not mean that saying this treatment produced an effect on 40% of the treated patients is wrong, that is still perfectly correct and valid. The same as saying that the polio vaccine protects 99 to 100% of people from paralysis, even if most of those people would not be paralyzed even without the vaccine.

This is as reported, which is what you can talk about. It makes no sense to just assume an arbitrary number.

But it's not reported, that's Raw Beer's point. The article only mentions the percentages for the drug and placebo groups, not the untreated.

If it was reported, you could provide the quote. But it ain't there.

As RB said, they never mention a 40% effect.

You understand that according to your own claim (total effect minus the effect of placebo) the vaccine efficacy would be 97.5% protection - 47.5% protection = 50% "efficacy", right?

You keep on inserting the word effect everywhere.

You don't subtract the effect of the placebo from the effect of the vax. You compare the rates (of infection, hospitalization, death...) from the two groups.

In your example, 2.5% of the vaxxed and 52.5% of the unvaxxed got infected, so the efficacy would be 95%, based on RB's quote. Not 50%!

But it's not reported, that's Raw Beer's point.

And that point is still irrelevant, what is reported is what can be discussed about, so unless you can find further information then it is perfectly valid to use what is reported as a basis for discussion. It is like pretending these results are valid only for some age groups because in the article it is not reported the ages of the patients.

As RB said, they never mention a 40% effect.

But I am, which is valid and correct since this is was was observed, again as reported. To say this is wrong you need information to contradict this, which you don't have. 40% of the people in the treated group had a reduction on alcohol intake, this can validly be called an effect.

You keep on inserting the word effect everywhere.

Because it is perfectly valid and correct to do it, to say this is not correctyou need to argue how and demonstrate it. My clais has never been that the authors said this, but that is correct and appropriate to do it.

You don't subtract the effect of the placebo from the effect of the vax. You compare the rates (of infection, hospitalization, death...) from the two groups.

But you can still present the effect observed in a group of people where the therapeutic intervention is used without it becoming wrong just because you don't substract the placebo.

In your example, 2.5% of the vaxxed and 52.5% of the unvaxxed got infected, so the efficacy would be 95%, based on RB's quote. Not 50%!

The 50% is following the mistaken approach that supposedly prove the effect is not 40% but only 20%. if you concede this number is not correct you are also saying that the argument that you should substract the 20% observed effect from placebo from the total is also completely incorrect.

40% of the people in the treated group had a reduction on alcohol intake, this can validly be called an effect.

You can only say that if you know the rate before treatment. That is not reported.

The 50% is following the mistaken approach that supposedly prove the effect is not 40% but only 20%. if you concede this number is not correct you are also saying that the argument that you should substract the 20% observed effect from placebo from the total is also completely incorrect.

RB explained clearly how he got the 20%, and it wasn't just a simple subtraction of percentages.

Using the method in the Cedar Sinai quote, I get 25%. Difference probably due to rounding off of small numbers. (80 - 60) / 80

You can only say that if you know the rate before treatment. That is not reported.

You can say that because that is is the only thing it is reported, it is a simple and valid assumption, to say this is not correct is when you need information to contradict the claim. Is like assuming this effect is not dependent on ethnic background, it is not something out of the ordinary even if the background of the patients is not reported, on the contrary if someone wants to make the claim this is not the case then that is where it becomes necessary to support that claim with information that is not included here.

RB explained clearly how he got the 20%, and it wasn't just a simple subtraction of percentages.

Yes it was, the explanation is still there.

Assuming their results are valid, it is only about 20% (5/24) where the effect was observed.

This is completely just a simple subtraction, something wrong according even to the provided reference.