Semaglutide’s Double Power for Weight Loss and Knee Pain

Semaglutide’s Double Power for Weight Loss and Knee Pain

September 2024?NEJM


The study, Once-Weekly Semaglutide in Persons with Obesity and Knee Osteoarthritis, explores the impact of weekly semaglutide injections. It focuses on weight loss and pain relief for people with obesity and knee osteoarthritis (OA). Knee OA, a degenerative joint condition, often causes significant pain and limits movement. This impact is especially severe in people with higher body mass indexes (BMIs). Research shows that weight loss can reduce OA symptoms, but limited studies focus on semaglutide’s role. Semaglutide, a GLP-1 receptor agonist, may aid weight loss and relieve knee pain. This study examines whether it offers a meaningful option for people managing both obesity and knee OA.


Study Design and Participant Profile

The study followed a randomized, double-blind, placebo-controlled format. It took place over 68 weeks at 61 sites across 11 countries, with 407 participants. Participants’ average age was 56, and their average BMI was 40. To qualify, they needed moderate knee OA confirmed by clinical and radiologic exams, along with moderate knee pain. The majority of participants (82%) were women. The study randomly assigned participants, in a 2:1 ratio, to receive either a weekly 2.4 mg injection of semaglutide or a placebo. Both groups also received counseling on physical activity and maintaining a reduced-calorie diet.


Primary Outcomes: Weight and Pain

The study focused on two main outcomes. The first was body weight change from baseline to the study’s end. The second was change in pain intensity, measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). This scale assesses pain on a scale from 0 – 100, with higher scores meaning worse pain. Additionally, researchers looked at physical function using the SF-36 Health Survey. This survey assesses well-being on a 0 – 100 scale, where higher scores show better physical health.


Significant Improvements for the Semaglutide Group

The study found promising results for semaglutide users. These participants achieved an average weight reduction of 14%, compared to only 3% for the placebo group. Pain levels improved significantly as well. The WOMAC pain score for the semaglutide group decreased by 42 points, while the placebo group saw only a 28-point drop. These differences were statistically significant. Semaglutide users also saw better improvements in physical function. Their SF-36 scores improved by 12 points on average, compared to 7 points for the placebo group. These findings suggest that semaglutide could benefit people with both obesity and knee OA. It offers both weight loss and significant pain relief.


Semaglutide’s Impact on Weight, Pain, and Mobility


The study carefully examined semaglutide’s safety profile. Serious adverse events were similar across groups, suggesting that semaglutide did not increase overall risk. However, treatment discontinuation was slightly higher in the semaglutide group due to side effects, mainly gastrointestinal issues. In the semaglutide group, 7% of participants stopped due to adverse effects. This compared to 3% in the placebo group. These findings align with previous research showing gastrointestinal issues as a common side effect of semaglutide.


A Promising Dual Benefit for Knee OA and Obesity

This study highlights the potential of semaglutide to help those struggling with obesity and knee OA. For people facing both weight challenges and knee pain, semaglutide offers a dual benefit. It provides effective weight loss and considerable pain reduction. The results suggest semaglutide not only helps patients lose weight, but it also improves their ability to be active. This may enhance their quality of life. While some side effects may lead a few to stop treatment, most found it beneficial. This study offers new hope for managing knee OA in people with obesity, providing a way to ease pain and improve mobility.

Dr. Tashko


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