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

• Published in: The American journal of clinical nutrition 2021-02, Vol.113 (2), p.314-323
• Main Authors: Gudbergsen, Henrik, Overgaard, Anders, Henriksen, Marius, Wæhrens, Eva Ejlersen, Bliddal, Henning, Christensen, Robin, Nielsen, Sabrina Mai, Boesen, Mikael, Knop, Filip Krag, Astrup, Arne, Rasmussen, Marianne Uggen, Bartholdy, Cecilie, Daugaard, Cecilie Laubjerg, Ellegaard, Karen, Heitmann, Berit Lilienthal, Bartels, Else Marie, Danneskiold-Samsøe, Bente, Kristensen, Lars Erik
• Format: Article
• Language: English
• Subjects: Adverse events; Aged; Arthritis; Biomedical materials; Body weight; Body weight loss; Clinical trials; Diet; Diet, Reducing; Female; Gastrointestinal system; Humans; Hypoglycemic Agents - therapeutic use; intervention; Knee; liraglutide; Liraglutide - therapeutic use; Male; Middle Aged; Obesity; Osteoarthritis; Osteoarthritis, Knee - therapy; Overweight; Pain; Pain - drug therapy; Placebos; Weight control; Weight loss; Weight Loss - drug effects
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/nqaa328

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). To determine the efficacy and safety of liraglutide in a 30 mg/d dosing in patients with overweight/obesity and KOA. 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. 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. 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.