The weight loss drug semaglutide may provide relief from knee arthritis pain

New research highlights the potential of weight-loss medications to ease arthritis symptoms and offers hope for improved mobility and pain relief.

In a recent study published in The New England Journal of Medicine, Researchers used a 68-week, large (61 centers in 11 countries) randomized clinical trial to evaluate the pain and weight-relieving effects of semaglutide in obese arthritis patients.

It was observed that a once-weekly subcutaneous injection of 2.4 mg of the novel antidiabetic miracle drug reduced body weight (13.7%) and pain (WOMAC = 41) significantly more than comparable placebo doses (3.2% and 27.5 points).

Consumption of semaglutide nearly doubles the increase in physical functioning compared to placebo (12.0 versus 6.5 points), further promoting somatic health, weight loss, and healthy aging. Safety was similar between case (semaglutide) and control (placebo) cohorts.

Taken together, these results represent another milestone in semaglutide's growing track record and highlight the drug's potential to replace conventional pharmacological interventions not only in the treatment of obesity and diabetes, but also related diseases, without compromising on existing antidiabetic modalities additional side effects occur.

background

Arthritis is an umbrella term for several diseases characterized by painful and often debilitating inflammation in joints and connective tissue between adjacent bones. Osteoarthritis of the knee (OK) is the most common of these diseases and causes patients significant pain, limited mobility and a significantly reduced quality of life.

To date, several risk factors have been identified associated with the development and progression of OK, with obesity (excess body weight) highlighted as the main contributor to the disease. High body mass index (BMI) has been shown to increase joint inflammation and worsen pain. Studies have shown that losing weight after the onset of arthritis can noticeably improve pain and stiffness.

Conventional clinical weight loss interventions have historically helped improve the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in the short term. Unfortunately, bariatric surgery represents a notable exception. Most conventional weight loss methods (dietary and physical activity interventions) unfortunately provide very patient-specific, short-term weight benefits that rarely last more than a few months and may even involve significant changes in patients' daily routines .

Although bariatric surgery promises almost guaranteed positive weight loss results, it is a largely invasive procedure with potentially adverse side effects, making it a “last resort” for severe obesity. Unfortunately, today's prevailing lifestyle (sedentary posture) and dietary habits (suboptimal diets such as the Western dietary pattern) are leading to an unprecedented escalation in obesity incidence, highlighting the need for safe, durable, efficient and non-surgical interventions to combat obesity-causing OK -Pain and combats excessive body weight.

About the study

The present study utilizes a placebo-controlled clinical trial methodology to elucidate the potential use of semaglutide, a recently developed antidiabetic drug, in the treatment of weight-related knee osteoarthritis.

Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist that belongs to the class of incretin mimetics. The drug has been extensively validated in obese/overweight and diabetic cohorts, with weekly subcutaneous (typically 2.4 mg) injections demonstrating generation-defining gains in long-term weight loss and diabetes treatment at lower side effect costs (compared to traditional pharmacological interventions).

While the benefits of weight control to relieve OC pain have already been demonstrated, the effectiveness and safety of the drug in older OC patients are still unknown.

The study cohort was derived from the Semaglutide Treatment Effect in People with Obesity (STEP) 9 study, a multicenter (61 sites in 11 countries) long-term evaluation of semaglutide using double-anonymized, randomized, placebo-controlled study methods. Adult STEP participants (>18) who had clinically validated OC and reported WOMAC scores >40 (100-point scale) were included and randomized into cases and controls (ratio 2:1).

Experimental procedures included weekly intervention administrations (2.4 mg semaglutide and equivalent placebo injections) and instruction on physical and dietary interventions that may improve weight and/or OC outcomes. Outcomes of interest included a reduction in BMI, WOMAC pain scores, or stiffness after 68 weeks of consistent intervention.

Study results

Of the thousands of participants in the STEP 9 study, 407 met the study inclusion criteria and were assigned to the case cohort (n = 271) and the control cohort (n = 136). The majority of participants were female (81.6%), of white ethnicity (60.9%), and had an average BMI of 40.3 kg m-2 (obesity is usually diagnosed using a BMI ≥30 as a cutoff point) .

The study results highlight the performance of semaglutide: The drug resulted in a 13.7% reduction in BMI and a 41.7 point reduction in WOMAC scores in case cohort members. In contrast, the placebo along with advice on diet and physical activity only resulted in a 3.2% and 27.5 point reduction among members of the placebo cohort. The secondary endpoint analysis confirmed these results and found that semaglutide consumption almost doubled SF-36 physical function scores (12.0 versus 6.5), highlighting its tremendous biological impact and multi-organ benefits.

Safety assessments produced statistically similar results in both cohorts: 10.0% of cases and 8.1% of controls reported adverse events (gastrointestinal symptoms were most common). Serious adverse reactions (requiring study discontinuation) were reported in 6.7% of cases and 3.0% of controls. These results demonstrate that semaglutide significantly outperforms placebo in excess weight loss, leading to a cascade of OC benefits.

Conclusions

The present study provides clinical evidence for the ameliorative benefits of semaglutide in knee arthritis compared to conventional pharmacological interventions for excessive BMI and the sequelae associated with OC (mainly pain and stiffness).

Study results show that semaglutide can result in more than 10% additional weight loss compared to current non-surgical procedures, resulting in a significant 41.7 point pain reduction in OC patients.

Although semaglutide exists, its potential to cause side effects is comparable to that of conventional modalities. Taken together, these results highlight that semaglutide is a safe and efficient agent for promoting weight loss and relieving chronic pain in OC patients.