Ozempic drug alleviates osteoarthritic knee pain

The ‘Ozempic drug,’ semaglutide, has been found to reduce moderately severe pain caused by knee osteoarthritis and improve physical functioning following weight loss, according to the results of a recent clinical trial by Novo Nordisk, the drug’s manufacturer.

Osteoarthritis in the knee joints is painful and restrictive, and with obesity, the risk of developing the condition is increased. But joint stress isn’t the only contributing problem. Fat is chemically active and constantly releases inflammation-causing proteins that travel to the joints.

Novo Nordisk, the Danish pharmaceutical company that manufactures the wonder diabetes-and-weight-loss drug semaglutide, sold as Ozempic (for diabetes) and Wegovy (for weight loss), recently published the results of a phase 3 clinical trial of the drug’s effect on obese adults with moderate knee osteoarthritis.

“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,” said Henning Bliddal, MD, from The Parker Institute at the Copenhagen University Hospital and the study’s lead and corresponding author. The Parker Institute researches disorders of the musculoskeletal system.

“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.”

The 68-week STEP 9 trial included 407 adult participants (81.6% women) at 61 sites in 11 countries. Participants were included if they had been diagnosed, by clinical exam and radiological imaging, with moderate knee osteoarthritis and at least moderate pain. Pain was measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire that scores three areas: pain, stiffness, and physical function. Scores for each subscale are tallied, with a possible range of zero to 20 for pain, zero to eight for stiffness, and zero to 68 for physical function. Usually, a sum of the scores for all three subscales gives a total WOMAC score. They were randomized to receive a once-weekly subcutaneous (under the skin) injection of 2.4 mg of semaglutide or placebo, in addition to counseling on physical activity and eating a reduced-calorie diet.

The trial participants’ mean baseline body weight was 239.5 lb (109 kg). Semaglutide led to a -13.7% mean change from baseline body weight at week 68 compared with -3.2% with placebo. Semaglutide also produced a mean change from baseline in WOMAC score of -41.7 points at the trial’s end versus -27.5 with placebo. Those taking semaglutide also had a greater improvement in physical functioning scores at week 68 compared with placebo, with a mean change of 12 vs. 6.5 points.

“Obesity is a complex metabolic disease associated with multiple co-morbid conditions, including knee osteoarthritis,” said Anna Windle, PhD, senior vice president of clinical development, medical and regulatory affairs at Novo Nordisk. “The STEP 9 results are encouraging and provide important information about the effect of semaglutide, a glucagon-like peptide-1 receptor agonist, on knee osteoarthritis outcomes in people with obesity. We look forward to working with regulatory authorities on next steps based on these findings.”

At present, semaglutide is not approved as a treatment for osteoarthritis pain.

The study was published in The New England Journal of Medicine.

Source: Novo Nordisk