{
  "_meta": {
    "purpose": "GLP-1RA·tirzepatide·orforglipron 중단 후 rebound trajectory 참조 envelope. 실제 임상 시험 요약치이며, 본 대시보드는 연구·post-marketing 보조용임.",
    "disclaimer": "본 데이터는 published trial summary 기반 요약치이며, 임상 의사결정에 직접 사용 금지.",
    "generated": "2026-05-20"
  },
  "references": [
    {
      "trial": "STEP-1 extension",
      "drug": "semaglutide 2.4mg",
      "design": "double-blind RCT 68주 후 off-treatment 52주 추가 관찰",
      "key_finding": "치료 중단 후 52주 시점 체중 회복률 약 2/3 (66.7%) regain of lost weight; cardiometabolic risk factor도 reversion",
      "source": "Wilding JPH et al. Diabetes Obes Metab 2022 (STEP-1 extension)",
      "trajectory_weeks": [0, 12, 26, 52],
      "weight_regain_frac_of_loss": [0.0, 0.20, 0.45, 0.67],
      "hba1c_reversion_frac": [0.0, 0.25, 0.55, 0.75]
    },
    {
      "trial": "SURMOUNT-4",
      "drug": "tirzepatide 10/15mg",
      "design": "36주 open-label lead-in 후 88주 무작위배정 (continued vs placebo)",
      "key_finding": "placebo로 전환된 군은 88주 시점 체중 +14% regain; tirzepatide 지속군은 추가 -5.5%",
      "source": "Aronne LJ et al. JAMA 2024 (SURMOUNT-4)",
      "trajectory_weeks": [0, 24, 52, 88],
      "weight_regain_frac_of_loss": [0.0, 0.35, 0.55, 0.75]
    },
    {
      "trial": "SELECT post-hoc (discontinuation subgroup)",
      "drug": "semaglutide 2.4mg",
      "design": "CVD post-hoc analysis of patients who discontinued during trial",
      "key_finding": "중단 후 체중·HbA1c regain 동시에 LDL·SBP 일부 reversion; CV 사건률은 trial-wide 추정",
      "source": "Lincoff AM et al. NEJM 2023 + post-hoc subgroup updates",
      "trajectory_weeks": [0, 26, 52],
      "weight_regain_frac_of_loss": [0.0, 0.40, 0.62]
    },
    {
      "trial": "SURMOUNT-MMO",
      "drug": "tirzepatide",
      "design": "ongoing morbidity·mortality outcome trial (long-term)",
      "key_finding": "장기 outcome (CV/all-cause mortality) 데이터 수집 중; 본 대시보드는 interim summary 만 인용",
      "source": "Eli Lilly press releases; clinicaltrials.gov NCT05556512",
      "trajectory_weeks": [],
      "weight_regain_frac_of_loss": []
    },
    {
      "trial": "ATTAIN-1 (orforglipron)",
      "drug": "orforglipron",
      "design": "Phase 3 oral non-peptide GLP-1RA in obesity",
      "key_finding": "주간 평균 체중 감량 ~13-15% (high-dose), 중단 후 rebound pattern은 injectable GLP-1RA 와 유사",
      "source": "Eli Lilly Phase 3 readout 2025-2026; preliminary publications",
      "trajectory_weeks": [0, 26, 52],
      "weight_regain_frac_of_loss": [0.0, 0.42, 0.65]
    }
  ],
  "envelope_summary": {
    "weeks": [0, 4, 12, 26, 52, 78, 104],
    "regain_lower": [0.0, 0.04, 0.14, 0.32, 0.55, 0.68, 0.75],
    "regain_central": [0.0, 0.07, 0.22, 0.45, 0.67, 0.78, 0.85],
    "regain_upper": [0.0, 0.10, 0.30, 0.58, 0.80, 0.90, 0.98]
  }
}