Wegovy and Knee Osteoarthritis for those with Obesity

This episode of Your Checkup examines a recent study investigating the effects of semaglutide, a medication used for weight loss, on individuals with both obesity and knee osteoarthritis. We will delve into how this trial was conducted, the key findings related to weight reduction and pain relief, and what these results might mean for patients experiencing these conditions. The study showed that semaglutide led to significant weight loss and pain reduction in participants. Join us as we explore the potential benefits and considerations of this new treatment approach

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(upbeat music)- Hi, welcome back to your checkup. We are the Patient Education podcast where we bring conversations from the doctor's office to your ears. On this podcast, we try to bring medicine closer to its patients. I'm Ed Delesky, a family medicine resident in the Philadelphia area.- I'm Nicole and I'm a nurse.- And we are so excited you were able to join us here again today. Our favorite game recently has been this, it's called "Pass the Pig." Have we talked about "Pass the Pig?"- I don't think so.- I have an obsession with this game and I hope to play it tonight. It's like Dice, but instead of Dice, it's pigs and the pigs land in various positions, we'll say. And they stand and the positions mean different points. And you can have groups big or small. I suppose you could do a little two on two game, but sometimes the bigger games are fun because there's more risk involved. Do you keep rolling or do you keep not?- No, we're not sponsored by "Past the Pigs" or anyone for that fact. But I love that game. And so that's what I wanted to talk about today. Do you have any thoughts about "Past the Pigs?"- Do I have any thoughts about "Past the Pigs?"- What's your favorite position?- I think a leaning jowler.- Yeah, I haven't seen it, but I haven't seen a double leaning jowler. I hope one day I might be able to, if I play enough, I might have to document it.- Oh my God. And then we had a nice dinner, it was a little while ago, but we didn't talk about it at Dock's Oyster House in Atlantic City. That was a really tasty meal. Lots of seafood there. And the best thing about seafood is when I see food, I eat it.(laughing) And their oysters were really good. And apparently they got a guy in the back. And if, what was his name?- Sophie?- Sophie.- Sophie, because it was an homage to, I hope you don't get canceled for this, Sophie's Choice, but instead they said it's, make it Sobie's Choice. And he actually picks what oysters you get. And in that instance, we had delicious oysters. You had a different type of oyster than I did, but was that?- Well, it was a cooked oyster. I don't know what else was on it, leaks, I think. And then they were called, what were they called? Champagne oysters?- Exactly.- Yep.- Champagne oysters. - Champagne oysters.- Yeah, that was delicious. I hope to go back and get some sort of bisque or soup. And they actually brought out a whole, a whole bagel before the meal, which I thought was really interesting.- Well, it wasn't a bagel.- It looked like a bagel.- Yeah. It was bagel shaped.- Certainly bagel shaped. Well, without further ado, let's get into the meat of the episode. Nick, what are we gonna talk about today?- Today we're talking about knee osteoarthritis. And specifically when it comes to knee osteoarthritis, we are going to talk about the effect that the hot topic medicine semaglutide has on knee osteoarthritis. Perhaps in the future we'll do a greater dive into my former near and dear favorite illness, knee osteoarthritis. But for now, what we're going to do is kind of go over a study that came out that explores the effect of somagletide on people who have obesity and knee osteoarthritis. And the headline is that it works, which was a really fascinating thing. So the background of this is that there's a relationship between having obesity and osteoarthritis of the knee. The teaching that I had, which I can't find anything specifically to back this up immediately, is that for every extra pound someone has on their body, the knee experiences four pounds. So two, eight pounds, three, 12 pounds, so on and so forth. But basically to get the point across, that there is a lot more stress on the knee when there is excess weight on the body. And knee osteoarthritis, if you've ever known someone, having a loved one or a neighbor who has it or perhaps you have it yourself, is a really tricky thing. There's conservative treatments up front, there's some stuff in the middle, and then at the end of it is the surgery to replace the knee. So having this as an option for someone who also has obesity is a really cool thing. So let's go into this study. It was called the Step 9 Study.- Who was in this study?- So it included 407 participants. They had a BMI of 30 or higher. And the participants also had clinical, or they had X-rays that demonstrated that they had at least moderate knee osteoarthritis and at least had a moderate amount of pain. And there are different scores that people use, one of them is called the Womac Pain Score. They use that to help measure on an objective level, someone's pain. The mean age of the participants was 56, and the mean BMI or average was 40.3. And like I mentioned, that Womac Pain Score was about a 70.9, it really doesn't mean a whole lot to the average person. And the majority of people in this study were women, because women are disproportionately affected by knee osteoarthritis compared to men.- So how did they do this study?- So this study was a 68 week, so well over a year. Double blind, randomized, placebo controlled trial, meaning that the participants and the people giving them the medicine did not know which medicine they were going to get, across 61 sites and 11 countries. And so there was a two to one ratio of people receiving some agglatine to those receiving placebo. And they also got guidance on physical therapy and reduced calorie intake in both groups. And they used the Womac Pain Score, like we said before, to measure, and they also to measure pain, and they also used a percentage of change in body weight compared to the incidence being in the study. There's other end points that show like physical function as well.- What were the findings of this study?- So in terms of weight loss, they demonstrated a clinically significant amount of weight loss of 13.7% in the semaglatide group versus 3% in the placebo group. And that was statistically significant. And the pain reduction, it was that, for the pain score that they used, there was a 41 point difference in the semaglatide group and a 27.5 point difference in the placebo group, which was also statistical significance, which made this an important finding. There was also an improvement in physical function. People with taking the semaglatide showed greater improvements in their physical function compared to those in the placebo group. The mean change, the average, was 12 points compared to those who weren't doing the semaglatide 6.5 points. And of course, there are people who had side effects, gastrointestinal issues were the most common side effect and the main reason for stopping the semaglatide group. That happened in 6.7% of people taking the drug and 3% of people who were in the placebo group. And so, this is an important study because it might provide hope for people who have obesity and have knee osteoarthritis. And we know that weight loss as a goal can be a benefit for osteoarthritis, but it can be a very challenging thing if their exercise capacity is limited by their osteoarthritis itself. Of course, this came with gastrointestinal side effects in some people and of course, any of this, you should be talking with your own doctor to see if this medicine or this strategy is right for you. But at the end of the day, they did find that this study showed the semaglatide was statistically significant, more effective than placebo for both weight loss and pain reduction in people who have obesity and knee osteoarthritis. I think this is a really cool development. In med school, I looked a lot into knee osteoarthritis. I did some writing about it in papers and people really close to me in my life. I had osteoarthritis in their knees, their hips and having this in the armamentarium to be able to help someone, it's really great. Even outside of all of this, I've had patients come back who are on semaglatide or tersepotide and they've come back and like my knee pain that I had when I saw you when I first started is gone. And then like right in the beginning of their treatment. And so whether it's osteoarthritis or this knee pain, what have you, I think there's like a world of hope out there. I really cool thing to see like these people are coming back. I saw someone this last week. She was like, I'm so happy. This is like my knee pain is all better and I just can't say enough. But that's all we wanted to talk about on this week's episode of your checkup. Hopefully you learned something for yourself. A loved one or a neighbor with a bum knee. Come back next week. We'll share this episode with a loved one or a neighbor. Check out our website or send us some fan mail. But until next time, stay healthy, my friends. I'm Ed Delesky.- I'm Nicole Aruffo.- Thank you and goodbye.- Bye.(upbeat music) This information may provide a brief overview of diagnosis, treatment and medications. It's not exhaustive and is a tool to help you understand potential options about your health. It doesn't cover all details about conditions, treatments or medications for a specific person. This is not medical advice or an attempt to substitute medical advice. You should contact a healthcare provider for personalized guidance based on your unique circumstances. We explicitly display any liability relating to the information given or its use. This content doesn't endorse any treatments or medications for a specific patient. Always talk to your healthcare provider for a complete information tailored to you. In short, I'm not your doctor.- I am not your nurse.- And make sure you go get your own checkup with your own personal doctor.(upbeat music)(upbeat music)(upbeat music)