We have learned alot about the GLP-1 agonist drugs such as Ozempic (Semaglutide), Wegovy, Mounjaro, Zepbound, to name a few. Yes, they help people lose weight and prevent diabetes which are their initial goals and intentions. What we didn’t expect was all the expanded benefits of GLP-1 agonists and their super-powers.
Several industry sponsored trials in 2024 explored potential benefits in patients with other conditions in which obesity is a risk factor. One of them is knee pain seen in knee osteoarthritis (OA). One randomized study investigated 400 patients with obesity (BMI of 40 kg/m2) and with painful moderate knee OA diagnosed by xray. One group took Semaglutide titrated to 2.4 mg weekly and the other was a placebo group. After 68 weeks, those in the Semaglutide group were significantly more likely than those in the placebo group to have a more than 50% reduction in pain scores! Average weight decreases were 14% with Semaglutide and 3% with placebo (NEJM JW Gen Med Dec 1 and N Engl J Med Oct 31; 391:1573).
We can expect similar studies in the future. It is unclear whether the condition of OA will eventually be listed as an FDA approved indication for GLP-1 agonists in patients with obesity. I have had positive feedback of significantly lowered back pain from my patients on these meds which ultimately helps them sleep better due to less inflammation. But thats another story and another blog for later. Stay tuned….