The Curbsiders Internal Medicine Podcast #514 Hotcakes: Oral Semaglutide, Fish Oil in ESRD, IV Iron During Infection, New US Dietary Guidelines, & Anticoagulation after Ablation in AFib
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Feb 16, 2026 Joshua Gilman, clinical cardiology commentator who reviews cardiovascular trials, joins to unpack recent high-impact studies. They cover oral semaglutide for weight loss and its tolerability, a striking fish oil trial in hemodialysis patients, IV iron given during infection and its methodological pitfalls, the new US Dietary Guidelines, and anticoagulation strategies after AF ablation.
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Match Trial Dose And Formulation
- Don’t equate OTC fish oil to trial formulations: the PISCES trial used 4 g/day with specific EPA/DHA content.
- Consider formulation and dose before applying trial results to patients on dialysis.
Adherence Confirmed Biochemically
- The PISCES trial measured adherence biochemically by sampling plasma phospholipid incorporation.
- The study followed patients for ~3.5 years across multiple centers, strengthening its findings.
Don’t Change Practice From That IV Iron Study
- Avoid using the Sohail et al retrospective TrinetX study to conclude IV iron improves survival during acute infection.
- Recognize immortal time bias and residual confounding can fully explain the apparent benefit.