Ozempic for Arthritis? GLP-1 Agonists Show Promise in Easing Symptoms in Obese Patients

Despite the fact that it affects millions of people each year, there still is no curative treatment for osteoarthritis — the most common form of arthritis that causes pain in the hands, knees, hips, spine, and elsewhere when the cartilage that protects the ends of the bones wears down over time.

And while researchers are hard at work on finding a cure — including an Advanced Research Projects Agency for Health-funded study co-led by University of Colorado Anschutz School of Medicine researchers Karin Payne, PhD, and Michael Zuscik, PhD — a new treatment has emerged to help a subset of osteoarthritis sufferers: GLP-1 agonist drugs like Ozempic, which have proven very effective as a weight-loss aid. In a recent clinical trial run by researchers in Denmark and Canada, patients with obesity and knee osteoarthritis who received a weekly dose of a GLP-1 agonist medication had a significant reduction in pain and improvement in physical function.

While she wasn’t involved in that study, Payne, associate professor of orthopedics, is interested in the promise of GLP-1 drugs to help ease osteoarthritis symptoms.

We sat down with Payne to discuss the GLP-1 research and the drugs’ potential to help patients.

What is osteoarthritis, and how common is it?

Osteoarthritis affects over 32 million Americans. It involves degeneration of the cartilage that lines our joints. Cartilage serves as a protective tissue at the end of our long bones and allows easy gliding of our joints when we walk and do everyday tasks. As the cartilage degenerates, it eventually causes the underlying bones to be exposed and rub against each other, causing a lot of pain. It often leads to needing a joint replacement.

What's the link between obesity and osteoarthritis?

Obesity is one of the major risk factors for developing osteoarthritis. Being obese affects the mechanical loading of your joints, and it can initiate or advance the progression of osteoarthritis.

So it would follow that an effective weight-loss drug like GLP-1s would have a benefit for obese patients with arthritis.

Yes. Even though osteoarthritis affects us all, either directly or through somebody in our family who has it, there's no cure for osteoarthritis. There aren’t even treatments that slow down the disease progression. It's a lot of palliative management. One of the initial discussions that is had when people are diagnosed is around weight management, because for people who are obese, it's been shown that weight reduction can ease symptoms. It's not surprising to see a study where people lost a significant amount of body weight, and it decreased their pain.

GLP-1s are all the rage right now, in terms of reducing weight; outside of the published study, have you heard much about their use in osteoarthritis?

I've been hearing more and more about them. There are a few review papers out now that speak to their potential and how they need to be explored more for osteoarthritis, so I think it's definitely picking up. I'm sure we're going to be seeing a lot more of this.

If a patient were to be put on a GLP-1 for this purpose, how important is it to also educate them about diet and exercise as ways to lose weight and reduce pain?

It's important to do it simultaneously. Sure, you can take a pill, the weight is off, but being active and moving your joints also has a beneficial effect. Many osteoarthritis patients get physical therapy to strengthen the muscles around the joints. So if you're further losing that muscle due to a GLP-1, you need to do physical activity and physical therapy to strengthen the joints. This is exciting research, but GLP-1 drugs are not a cure for OA. There definitely is more work to be done to understand exactly what the drugs are doing and the long-term benefits or risks.

How do you see GLP-1s tying into the research that you and Dr. Zuscik are leading?

We're part of a multi-institutional ARPA-H-funded project where we're trying to regenerate the cartilage in osteoarthritis patients. Even if you don’t feel the pain as much, your cartilage is not getting regenerated with the GLP-1, and you still may need a joint replacement in the end. Maybe a combined approach, where you're reducing the pain through weight management, but you're also trying to regenerate the cartilage, is the way to go in the future.