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

Henrik Gudbergsen, Anders Overgaard, Marius Henriksen, Eva Ejlersen Wæhrens, Henning Bliddal, Robin Christensen, Sabrina Mai Nielsen, Mikael Boesen, Filip Krag Knop, Arne Astrup, Marianne Uggen Rasmussen, Cecilie Bartholdy, Cecilie Laubjerg Daugaard, Karen Ellegaard, Berit Lilienthal Heitmann, Else Marie Bartels, Bente Danneskiold-Samsøe, Lars Erik Kristensen, Henrik Gudbergsen, Anders Overgaard, Marius Henriksen, Eva Ejlersen Wæhrens, Henning Bliddal, Robin Christensen, Sabrina Mai Nielsen, Mikael Boesen, Filip Krag Knop, Arne Astrup, Marianne Uggen Rasmussen, Cecilie Bartholdy, Cecilie Laubjerg Daugaard, Karen Ellegaard, Berit Lilienthal Heitmann, Else Marie Bartels, Bente Danneskiold-Samsøe, Lars Erik Kristensen

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.

Keywords: diet; intervention; liraglutide; obesity; osteoarthritis.

© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.

Source: PubMed

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