What is the role of Semaglutide in the treatment of knee osteoarthritis? Latest scientific evidence from recent study published in the New England Journal of Medicine

The latest evidence from The New England Journal of Medicine underscores semaglutide’s potential role in improving pain and function in knee OA patients by achieving substantial weight loss.

This recent study published on October 30, 2024, in the New England Journal of Medicine (N Engl J Med 2024;391:1573-1583) provides new evidence suggesting that semaglutide, already approved for type 2 diabetes and obesity management, may also play a beneficial role as part of a comprehensive approach to treating knee osteoarthritis in patients with obesity.

A 68-week, randomized, double-blind, placebo-controlled trial involving individuals with obesity (BMI ≥30) and moderate knee OA (STEP 9 Trial) was conducted across multiple international sites. Participants were assigned to once-weekly subcutaneous semaglutide or placebo, along with counseling on physical activity and a reduced-calorie diet.

Using the WOMAC pain score (0–100 scale), participants on semaglutide experienced an average reduction of about 41.7 points, significantly greater than the 27.5-point improvement seen in the placebo group.

There was an average of approximately 13.7% loss in body weight in the semaglutide group and around 3.2% reduction in the placebo group. This suggests that weight reduction facilitated by semaglutide leads to meaningful improvements in osteoarthritis-related knee pain.

Improvements were also seen in the SF-36 physical-function score, a measure of overall physical well-being. Patients receiving semaglutide showed greater gains than those on placebo, indicating enhanced mobility and daily functioning.

The primary advantage appears to be related to substantial weight loss. By reducing the load on weight-bearing joints, semaglutide indirectly alleviates osteoarthritis-related pain and improves mobility.

Semaglutide is at the moment not considered a disease-modifying osteoarthritis drug per se. However, it can complement existing osteoarthritis management strategies, such as physical therapy, exercise, and analgesics—by tackling a root contributor to disease burden: excess body weight.

Patients with obesity-related knee osteoarthritis who have struggled with traditional weight-loss methods may particularly benefit from semaglutide therapy as an adjunct to lifestyle interventions.