THE EFFECT OF WEIGHT LOSS AND GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONIST ON STRUCTURAL CHANGES IN KNEE OSTEOARTHRITIS: SECONDARY ANALYSIS OF THE RANDOMISED, PLACEBO-CONTROLLED LOSEIT TRIAL

OBJECTIVE

To compare the effect of weight loss and glucagon-like peptide-1 receptor agonist (GLP-1RA) (liraglutide), relative to weight loss and placebo, on structural knee osteoarthritis.

METHODS

This secondary analysis followed a superiority framework of data from the LOSEIT trial, a randomised, parallel-group, placebo-controlled trial. Participants aged 18 to 74 years with overweight (BMI ≥27 kg/m²), symptomatic and early-to-moderate radiographic knee OA were recruited. They underwent 8-week intensive diet intervention followed by randomisation to receive a GLP-1RA (liraglutide 3 mg/d) or placebo for 52 weeks. The primary outcome was the change in radiographic medial minimal joint space width (mmJSW). Analyses were conducted on the intention-to-treat population.

RESULTS

From November 14, 2016, through September 12, 2017, 156 participants were randomly assigned to GLP-1RA (n = 80) or to placebo (n = 76). As reported in the primary analysis of the data, the GLP-1RA group lost more weight than the placebo group (mean difference, - 3.21 kg, 95%CI: - 6.39 to - 0.03; P=0.050). The GLP-1RA group demonstrated an increase in mean mmJSW of 0.22 mm (95%CI: 0.06 to 0.38) while the placebo group did not change (0.07 mm, 95%CI: - 0.11 to 0.25). No evidence of a difference in mean mmJSW was observed between groups (0.15 mm, 95%CI: -0.06 to 0.36; P=0.17).

CONCLUSION

While the results indicate a potentially favourable effect on mmJSW within the GLP-1RA group, the observed difference in structural knee OA changes on radiographs compared to placebo did not reach statistical significance.