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Liraglutide after diet-induced weight loss for pain and weight control in knee osteoarthritis: a randomized controlled trial.

The Parker Institute, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark. Department of Physical and Occupational Therapy, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Copenhagen Denmark. Research Initiative for Activity Studies and Occupational Therapy, Research Unit for General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark. Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark. Department of Radiology, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark. NNF Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark. Research Unit for Dietary Studies at The Parker Institute, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark. Department of Public Health, Section for General Medicine, University of Copenhagen, Copenhagen, Denmark. Department of Neurology, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Bispebjerg, Denmark.

The American journal of clinical nutrition. 2021;(2):314-323
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Abstract

BACKGROUND Weight loss is critical for preventing and managing obesity-related diseases. There is a notable lack of valid and reliable means to manage patients with overweight/obesity and knee osteoarthritis (KOA). OBJECTIVE To determine the efficacy and safety of liraglutide in a 30 mg/d dosing in patients with overweight/obesity and KOA. METHODS The trial was designed as a randomized controlled trial including patients between the age of 18 and 74 y with KOA and a BMI ≥27 (measured in kg/m2).Patients underwent a pre-random assignment diet intervention (week -8 to 0). At week 0, patients having lost >5% of their body weight were randomly assigned to liraglutide 3 mg/d or placebo for 52 wk. The coprimary outcomes were changes in body weight and the Knee injury and Osteoarthritis Outcome Score (KOOS) pain subscale from week 0 to 52. RESULTS In total, 168 patients enrolled and 156 were randomly assigned to receive liraglutide or placebo. Patients experienced a significant reduction in body weight and KOOS pain during the pre-random assignment dietary intervention period (week -8 to 0). From week 0 to 52 there was a significant difference in body weight between the liraglutide and placebo group (mean changes: -2.8 and +1.2 kg, respectively; group difference, 3.9 kg; 95% CI: -6.9, -1.0; P = 0.008). There was, however, no group difference in KOOS pain (mean changes: 0.4 and -0.6 points, respectively; group difference, 0.9 points; 95% CI: -3.9, 5.7; P = 0.71). Treatment-emergent adverse events related to the gastrointestinal system were experienced by 50.2% and 39.2% of patients in the liraglutide and placebo groups, respectively. CONCLUSIONS In patients with KOA and overweight/obesity liraglutide added after an 8-wk pre-random assignment diet induced a significant weight loss at >52 wk but did not reduce knee pain compared to placebo. This trial was registered at clinicaltrials.gov as NCT02905864.

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Publication Type : Randomized Controlled Trial

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