Does Semaglutide Reduce Pain for Patients With Obesity and Knee Osteoarthritis?

In a 68-week, randomized, double-blind, placebo-controlled study, participants with obesity and moderate knee osteoarthritis experienced greater reductions in body weight and pain when treated with once-weekly semaglutide (2.4 mg) compared with placebo.

The aim of this study was to identify effective, non-surgical interventions to manage knee osteoarthritis in patients with obesity. Weight loss has been shown to alleviate osteoarthritis symptoms, but the potential of glucagon-like peptide-1 (GLP-1) receptor agonists, specifically semaglutide, for reducing weight and associated knee osteoarthritis symptoms had not been comprehensively studied. The researchers sought to assess the effects of semaglutide on body weight, pain, and physical function in this population.

Researchers recruited 407 participants from 61 sites across 11 countries, all of whom had a BMI greater than or equal to 30 and moderate knee osteoarthritis with at least moderate pain. Participants were randomized in a 2:1 ratio to receive weekly subcutaneous injections of semaglutide or placebo, in addition to guidance on physical activity and a reduced-calorie diet. The primary outcomes were the percentage change in body weight and the change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score (0-100 scale) from baseline to week 68. Physical function, measured by the 36-Item Short Form Health Survey (SF-36) physical-function score, was a key secondary outcome.

Semaglutide resulted in a mean body weight reduction of 13.7%, compared with a 3.2% reduction in the placebo group (P < .001). Semaglutide also demonstrated a decrease in pain, with a mean reduction in the WOMAC pain score of 41.7 points versus 27.5 points with placebo (P < .001). Results indicated that semaglutide led to better outcomes than placebo across all outcomes. In terms of physical function, the semaglutide group had a mean increase of 12.0 points on the SF-36 score compared to a 6.5-point increase in the placebo group (P < .001), indicating improved well-being and mobility. Adverse events were comparable between the two groups; however, 6.7% of participants in the semaglutide group discontinued treatment due to adverse events, mainly gastrointestinal, compared to 3.0% in the placebo group.

Limitations of the study include its relatively short duration for assessing long-term effects.

“Among participants with obesity and knee osteoarthritis with moderate-to-severe pain, treatment with once-weekly injectable semaglutide resulted in significantly greater reductions in body weight and pain related to knee osteoarthritis than placebo,” the study authors concluded.

Reference

Bliddal H, Bays H, Czernichow S, et al. Once-weekly semaglutide in persons with obesity and knee osteoarthritis. Engl J Med. 2024;391(17):1573-1583. doi:10.1056/NEJMoa2403664