Osteoarthritis: Ozempic, Wegovy may help reduce knee pain

Evan Walker
Evan Walker TheMediTary.Com |
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A new trial finds that GLP-1 agonists may help reduce knee osteoarthritis-related pain. Westend61/Getty Images
  • The use of GLP-1 medications such as semaglutide — more widely known under the brand names of Ozempic and Wegovy — have greatly increased over the last few years.
  • There has also been an increase in research examining other benefits these types of drugs might offer aside from type 2 diabetes management and weight loss.
  • Recent results from a phase 3 clinical trial show that semaglutide may help reduce knee osteoarthritis-related pain in people with obesity.

The use of glucagon-like peptide-1 (GLP-1) medications such as Wegovy and Ozempic has greatly increased over the last few years.

While these drugs are mainly used to help control type 2 diabetes and boost weight loss, over the last few years, there has been a lot of research surrounding GLP-1 medications, such as semaglutide, and how they provide additional benefits.

For example, recent studies report that GLP-1 drugs may have neuroprotective benefits, lower Alzheimer’s disease risk, and offer protection against cardiovascular disease.

Now, new clinical trial results recently published in The New England Journal of Medicine show that semaglutide may also help reduce knee osteoarthritis-related pain in people with obesity.

This new study featured the results from the STEP 9 phase 3 clinical trial conducted by healthcare company Novo Nordisk aimed at evaluating the efficacy of semaglutide versus placebo as an additional to lifestyle modifications — such as eating a reduced-calorie diet and exercising — in lowering weight and knee osteoarthritis-related pain in patients with obesity.

Researchers recruited 407 participants with an average age of 56 and body-mass index (BMI) of 40.3 for the study, who received either a 2.4 mg dose of semaglutide once a week or a placebo for 68 weeks.

At 68 weeks, researchers found that participants taking semaglutide experienced a mean decline in their body weight by 13.7%, compared to a 3.2% decrease in those taking the placebo.

Researchers also evaluated study participants’ Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores during this study. WOMAC is a patient-reported questionnaire that helps rank pain on a scale of zero to 100, with higher numbers indicating more pain.

Scientists discovered that those taking semaglutide experienced a mean decrease in their WOMAC pain score of 41.7 points from 70.9 at the start of the study, compared to those taking the placebo whose WOMAC scores only decreased by 27.5 points.

“Obesity-related knee osteoarthritis is a progressive condition that can lead to pain and stiffness of the knee and impair critical daily functions such as walking or moving around,” Henning Bliddal, MD, MSci, clinical professor in the Department of Clinical Medicine and director of the Parker Institute at Copenhagen University Hospital in Denmark and lead author of this study says in a press release.

“The risk of developing the condition is more than four times higher in people with obesity. Weight reduction along with physical activity is often a recommended approach to managing painful symptoms, but adherence can be challenging. There is a significant need for non-surgical and sustainable treatment options for those living with obesity-related osteoarthritis. The STEP 9 trial aimed to provide rigorous evidence as to how semaglutide may help these people,” Bliddal says.

MNT also spoke with Bert Mandelbaum, MD, sports medicine specialist and orthopedic surgeon at Cedars-Sinai Kerlan-Jobe Institute and Co-Director of the Regenerative Orthobiologic Center at Cedars-Sinai Medical Center in Los Angeles, about this study.

“Certainly we have always known that obesity is a risk factor for not only the onset of osteoarthritis, but the progression of it — there is no question about that. When you have a study like this that shows that there’s two things that are happening at one time. One is that obviously their patients are losing weight, so there’s a physical and mechanical aspect, but also there’s something about semaglutide that also has an anti-inflammatory (effect).”
— Bert Mandelbaum, MD

“It’s not proven in this study, but there have been other studies that show that (semaglutide) reduces cardiovascular risks. And the mechanisms of that are that it is functionally an anti-inflammatory as well. It has another effect, creating a decreased inflammation that affects blood vessels in and of themselves, as well as other catabolic mediators such as the Health">interleukins and TNF (tumor necrosis factor), and other metalloproteases seem to be inhibited as part of its inhibitory inflammatory effect,” Mandelbaum said.

Mandelbaum said doctors are looking for help in reducing pain from osteoarthritis, whether it’s related to obesity or not.

“Obesity is just a negative factor that worsens the challenge for us. We’re trying to reduce the amount of what we call catabolism and create an anabolic environment for the joints,” he explained.

“I think if researchers have found that we could reduce cardiovascular disease with these medicines, we can reduce the pain from osteoarthritis,” Mandelbaum continued.

“At the end of the day, the orthobiologic family, we have to look at other things that can make a difference, along with taking Wegovy or any of the other GLP-1s. So I think it’s an interesting study, but (it) really portends us to really think about what our next steps are so we can get into more adjuvant approaches, in addition to this, at the same time,” he added.

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