• A new study suggests semaglutide use may help reduce severe knee pain.
• People also lost weight during the course of the study.
• The reduction in pain likely occurred because weight loss leads to less joint stress.
• Semaglutide is also capable of balancing blood sugar and reducing inflammation.
• Experts say we are likely to see continued advances with drugs like semaglutide.

While semaglutide (sold under the brand names Ozempic and Wegovy) is best known as a drug for the treatment of type 2 diabetes and obesity, research is increasingly finding that it may have applications outside of these uses.

For example, recent studies have found it could help reduce the risk of opioid overdose, early death, hidradenitis suppurativa, and Alzheimer’s disease.

Now, new research published on October 30, 2024, in The New England Journal of Medicine adds to the list, finding that once-weekly semaglutide usage was associated with relief from the severe knee pain associated with obesity and osteoarthritis.

According to the Arthritis Foundation, osteoarthritis is a “wear and tear” condition. It can cause:

• cartilage breakdown
• misshapen bones
• chronic pain
• inflammation
• stiffness
• loss of mobility

Obesity is one cause of osteoarthritis due to the strain that added weight put on joints, especially the knees, hips, and the spine.

How semaglutide use is linked to knee pain relief

The study enrolled 407 patients with an average age of 56 to evaluate the effects of semaglutide use on knee pain.

Their average body mass index (BMI) was 40.3. A BMI of 30 or greater is classified as obesity.

Additionally, these individuals had an average WOMAC pain score of 70.9 on a scale of 0 to 100, with higher scores meaning worse pain.

All were diagnosed with moderate to severe knee pain.

The majority of study participants (81.6%) were female.

Everyone, regardless of whether they received semaglutide or not, was provided with counseling on diet and exercise.

Over the course of the 68-week study, people using semaglutide lost an average of 13.7% of their body weight compared with only 3.2% weight loss in those who did not use the drug.

Those using semaglutide also experienced an average reduction in their WOMAC pain score of 41.7 points, whereas the untreated group had an average decrease of 27.5 points.

Why semaglutide might provide relief for severe knee pain

Sandeep Singh, MS, MBBS, an orthopedic surgeon with Clinic Spots, said the biggest reason that Ozempic might provide pain relief really comes down to weight reduction.

“In osteoarthritis, every pound of weight lost takes about four pounds of pressure off the knee joints,” he explained. “So, the study’s average13.7%weight loss likely brings considerable relief to the joints just from reducing that mechanical load.”

However, according to Singh, there may be more at play. The medication could have certain direct effects on relieving pain.

“We’re starting to see that GLP-1 receptor agonists, like Ozempic, may have anti-inflammatory effects,” he said, “which could help with knee pain beyond weight loss alone.”

Singh said that inflammation is a major factor in osteoarthritis which can lead to joint pain and deterioration.

“Even a slight reduction in inflammation can lead to a noticeable improvement in pain and stiffness,” he said.

Singh also pointed to semaglutide’s ability to stabilize blood sugar, which can bring down inflammation.

“This mix of lowered inflammation, reduced joint pressure, and better blood sugar control could potentially work together to relieve osteoarthritis symptoms,” he said.

How weight loss drugs may help improve future overall health

William Seeds, MD, a board certified orthopedic surgeon and the owner of Redox Medical Group, was enthusiastic about the findings of the study.

“This continues to be exciting evidence in the areas outside of weight loss that benefit improved quality of life issues and have profound effects on reducing healthcare dollars in the future second to the devastating effects of Osteoarthritis on the healthcare system,” he said.

Seeds added that he believes we are going to see continued advances in drugs like semaglutide.

“My belief is as we get better at improving the overall efficiencies of cellular mitochondrial function with continued advances in GLP1RAs we will be humbled by the continued beneficial signaling pathways that improve overall health,” he said.

Seeds further noted that we are seeing advancement in GLP-1 receptor agonists going from semaglutide (binds with GLP-1 receptors) to tirzepatide (binds with GLP-1 and GIP receptors) to retatrutide (binds with GLP-1, GIP, and glucagon receptors).

“The evolution from GLP-1 receptor agonists (semaglutide) to dual (tirzepatide) and triple agonist (retatrutide) represents a significant progression in enhanced cellular efficiencies, optimizing metabolic responses and therapeutic outcomes,” he said.

“These are exciting times in peptide development and clinical translation to life changing results!”

Takeaway

A study published in The New England Journal of Medicine found that using the type 2 diabetes and weight loss drug semaglutide was linked with improved pain scores in those with osteoarthritis, a painful and degenerative condition affecting the joints.

The weight loss engendered by this medication reduces the strain on joints.

Additionally, semaglutide helps to balance blood sugar and reduce inflammation. The sum of these effects is likely what reduces osteoarthritis pain in the knee.

Experts say we are likely to see continued beneficial effects from drugs like semaglutide due to the ways GLP-1 drugs impact signaling pathways.