Anti-obesity drug has life-changing benefits for arthritis

A blockbuster weight loss drug Sharply reduces pain from obesity-related knee arthritis and improves a person’s ability to participate in activities such as walking. This is evident from a clinical trial conducted in eleven countries – the first of its kind to prove this the new wave of anti-obesity drugs can treat arthritis. The drug, semaglutide, provided pain relief comparable to opioid medications.

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By the end of the study, many participants’ pain had decreased so much that they were no longer eligible for the study, says Henning Bliddal, a rheumatologist at Copenhagen University Hospital in Bispebejerg and Frederiksberg, who helped conduct the study . “They received a therapy that was so effective that they were more or less treated outside of the study,” he says.

The results are “important and could be helpful” for people with knee osteoarthritis, said Leigh Callahan, an epidemiologist at the University of North Carolina, Chapel Hill.

The findings were published today in the New England Journal of Medicine¹. The trial was sponsored and designed by Novo Nordisk, based in Bagsværd, Denmark, which makes semaglutide, a drug sold as Ozempic for the treatment of diabetes and Wegovy for the treatment of obesity. Bliddal briefly served as a paid consultant to the company during trial planning.

Spreading the plague

Osteoarthritiswhich causes stiff, painful joints, is one of the most common age-related diseases, and the knee is the most commonly affected joint. People who are obese are at greater risk of developing arthritic knees because they put extra pressure on their joints. Obesity also worsens symptoms, Callahan says. Pain from the condition can keep people from exercising, Bliddal says, making it extremely difficult for them to lose weight through lifestyle changes alone.

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The trial involved around 400 participants on five continents and randomly assigned them to weekly injections of semaglutide or a placebo. They also received advice about healthy eating and exercise. When the trial began, the participants were overweight and their average score on a 100-point pain scale was 71 – high enough that walking was painful.

After 68 weeks of injections, participants taking semaglutide had lost much more weight than those taking the placebo. They also reported a much larger drop on the pain scale: an average of 42 points, compared to an average of 28 points for placebo recipients. These participants also noticed greater improvement in daily functioning, such as climbing stairs.

The improvement likely results in part from reduced stress on the knee due to weight loss, the authors write. But semaglutide also has anti-inflammatory effectswhich could explain the pain relief.

Despite the benefits, Bliddal is concerned about the long-term prospects for those taking semaglutide to relieve knee arthritis. “Are these guys going to continue taking semaglutide forever” to manage their pain? People who stop taking the drugs generally regain the weight they lostand the medicines are expensive; a month’s supply can cost hundreds of dollars.

Callahan emphasizes that while the results seem “very exciting,” it is important that people supplement anti-obesity medications with lifestyle changes for long-term weight maintenance.