Could be an increased efficiency towards a negative outcome. Older peoples bodies maybe have different uptake of the serum. Maybe that means there should be a spectrum of dosages depending on specific characteristics of the person, like weight, age etc?
True, except for patients age 55+. They did not receive the initial half-concentration dose. That's almost certainly why those receiving the half-concentration dose experienced much higher efficacy (90% vs 62%) — they were younger and had fewer co-morbidities.
That's right. The impact that this has on the quality of the medication is dependent on the dose-response curve. I wouldn't expect this to be a big deal for painkillers, for instance, but it could easily cause noticeable differences elsewhere.
I bet we could optimize the dose depending on sex, weight, age or other factors (if we knew how it depended on them) but this is not how it is done. The dose is the same for all adults.
Maybe it's vanishingly unlikely one has unknown deficits.
One problem with daily recommended/minimum/maximum doses is that they come without bandwidths. What's high for person X maybe dangerously low for Y. Knowing your optimal levels is basically impossible to know. And perhaps there is no such thing, maybe there are multitudes of optima, and maybe it person specific bandwidths are enormous as well. It seems evolutionary likely that we can deal well with huge variety.
The difference is that in that trial they weren't looking at health outcomes. They were looking at people's blood and measuring antibodies.
If it turns out that 25mg produces a small amount of antibodies - but that small amount is still more than enough to prevent the same number of hospitalizations that 100mg does - then it make sense to go with that.
The dosage trials were only used to study the microbiology. Not the death/hospitalization outcomes.
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