Injectable semaglutide may reduce body weight and knee osteoarthritis-associated pain: NEJM

A new study published in the New England Journal of Medicine showed that once-weekly injectable semaglutide led to considerably higher reductions in body weight and knee osteoarthritis pain among patients with obesity and moderate-to-severe pain. It has been shown that losing weight can reduce the discomfort associated with osteoarthritis of the knee. Not much research has been done on how glucagon-like peptide-1 receptor agonists affect the course of osteoarthritis in the knees of obese individuals. Thereby, Henning Bliddal and associates conducted this research to rule out the efficacy of semaglutide in individuals with osteoarthritis and obesity.

A 68-week, double-blind, randomized, placebo-controlled study was carried out at 61 locations throughout 11 nations. In addition to counseling on physical activity and a lower-calorie diet, participants with obesity (defined as a body-mass index [BMI] of ≥30] and a clinical and radiologic diagnosis of moderate knee osteoarthritis with at least moderate pain were randomized, in a 2:1 ratio, to receive once-weekly subcutaneous semaglutide (2.4 mg) or a placebo. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score (which ranges from 0 to 100, with higher scores indicating worse results) and the percentage change in body weight were the main endpoints. The 36-item Short Form Health Survey (SF-36), version 2's physical-function was a crucial confirmatory secondary end objective, where higher scores denoted more well-being.

There were a total of 407 competitors in all, where the average WOMAC pain score was 70.9, the average age was 56, and the average BMI was 40.3. Women made up 81.6% of the participants overall. Semaglutide caused a mean decrease in body weight of 13.7% from baseline to week 68, while a placebo caused a decrease of 3.2% (P<0.001). At week 68, the average change in the WOMAC pain score was -27.5 points with a placebo and -41.7 points with semaglutide (P<0.001).

The SF-36 physical-function score improved more in the semaglutide group than in the placebo group (mean change, 12.0 points vs. 6.5 points; P<0.001). In both groups, the frequency of severe adverse events was comparable. 3.0% of participants in the placebo group and 6.7% of those in the semaglutide group experienced adverse events that resulted in the permanent cessation of the trial regimen. Whereas, the most frequent cause of termination was gastrointestinal issues. Overall, the findings of this study clearly indicates the positive effects of once-weekly dose of semaglutide in obesity and osteoarthritis based knee pain.

Source:

Bliddal, H., Bays, H., Czernichow, S., Uddén Hemmingsson, J., Hjelmesæth, J., Hoffmann Morville, T., Koroleva, A., Skov Neergaard, J., Vélez Sánchez, P., Wharton, S., Wizert, A., & Kristensen, L. E. (2024). Once-Weekly Semaglutide in Persons with Obesity and Knee Osteoarthritis. In New England Journal of Medicine (Vol. 391, Issue 17, pp. 1573–1583). Massachusetts Medical Society. https://doi.org/10.1056/nejmoa2403664