New Hope for Treating Knee Osteoarthritis: Study Finds GLP-1 Drugs Improve Cartilage Even Without Weight Loss
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Beast-of-Burnley
Explorer
I've got osteoarthritis myself, and my knee discomfort plus overall knee condition has gotten noticeably better (I used branded Mounjaro for roughly 4-5 months including the golden dose, then grey Reta for about the past 2 months) after dropping a bit more than 6 stone across roughly 10 months.
I had chalked that big improvement up to the weight coming off, but maybe the glp's contributed something extra too!
I had chalked that big improvement up to the weight coming off, but maybe the glp's contributed something extra too!
It never fails to amuse me when these "news" sites cover glp-1 use as though it were some brand-new discovery. The clinical trial looking at OA knee pain and sema came out 18 months back…
https://www.nejm.org/doi/abs/10.1056/NEJMoa2403664
https://www.nejm.org/doi/abs/10.1056/NEJMoa2403664
oldrunnerguy
Explorer
There's now one more item on my personal list of reasons for using a GLP1. Here's what I have so far, in no specific order:
1. A1C goes down.
2. Lipids look better.
3. Arthritis pain is less.
4. The compulsion to binge on chocolate drops substantially.
5. My scale shows a lower visceral fat percentage.
6. Alzheimer's disease risk is lower.
7. Risk of adverse cardiovascular events (myocardial infarction, etc.) is lower.
8. Blood pressure is down.
9. Colorectal cancer risk is reduced.
10. By far the least significant for me: body weight is reduced. Losing weight isn't something I need, but since I'm a vain person, I look pretty good in the mirror.
Anyone else is welcome to add reasons.
To me, those two things aren't really the same at all. The trial you brought up, which Novo paid for, ties weight reduction to better OA outcomes. That hardly comes as a surprise, since the usual line is that for each pound you drop, the load on your knee joint falls by roughly 4 pounds. So losing any amount of weight should ease pain to some degree.
What the newer study does is draw a different kind of connection, suggesting GLP drugs are doing something we don't fully grasp yet. I happen to fall right in the middle of the Venn diagram on multiple counts, so I'm watching this closely. Last year it was the effect on heart problems that went past what weight loss alone could explain. This one hints at OA gains beyond weight loss alone, plus the bonus of cartilage remodeling, which earlier studies never showed.
Zydeceltico
Explorer
Same here — and I'm keeping a very close eye on this too, since I have skin in the game.
Speaking from my own journey: it's been roughly 9 months now and I'm down 49 pounds. My BMi has just gone below 26. Body fat went from 26 and change down to 18.5, and I picked up muscle along the way.
What that has meant in real life:
Apnea - no longer using CPAP
Afib - no longer on meds
OA - zero pain, zero weakness, only a bit of leftover crepitis crackle in one knee when I take the stairs.
Binge drinking - a thing of the past
I keep up with the research because I want to grasp what on earth all the GLP receptors connect to. It isn't just about losing weight.
Appreciate it! After taking another look at this study, I realize it isn't the one that was on my mind. I'll need to dig back through and try to track down the research article I was actually recalling. Maybe what I was remembering was OSA rather than OA — though I was fairly sure it covered both.
My recollection was that it makes sense for OSA and OA to improve alongside weight reduction, and I wondered how the researchers could separate how much of the benefit came from losing weight versus how much did not.
Couldn't agree more, 100%. My reaction when I came across the earlier one and noticed Novo was behind it: a flat "well duh!" At that point they might as well have paid for research proving GLP1s line up directly with pants size?!?!?
Jerrey
Explorer
Right — tirzepatide has had a reputation for strong anti-inflammatory action for a good while now. Many of us probably figure that any drop in pain comes purely from the remarkable weight loss, yet these GLP medications appear to offer additional advantages to those of us dealing with arthritis as we age.
buffoon24
Explorer
The mechanism proposed in this Cell paper is wild! GLP-1 receptors show up on many different cell types, not only in the pancreas and gut. According to the study, chondrocytes carry GLP-1 receptors, which means your Tirz/Sema/Reta etc. can work directly on cartilage cells. The way it acts is more anti-inflammatory than metabolic.
Crumplestiltskin
Explorer
This list caught my attention, particularly the part about arthritis pain! Weight loss isn't something I need, so I worry about losing too much or something like that, but these benefits sound amazing. My knees have been bad since my teenage years, and the situation has only gotten worse. Which one did you use to get those benefits?
oldrunnerguy
Explorer
I'm on Reta at the moment, and I'm getting ready to make the change over to Tirz.
Dogmandu
Explorer
Can I ask what's behind that? A lot of people move the opposite way, switching from Tirz to Reta. The Phase 3 results for Reta and osteoarthritis looked very promising.
This research is excellent and carries genuine clinical weight. What it brings to the surface is whether halting GLP-1 use causes the weight-independent advantages to disappear.
If a follow-up study were to examine that question, it would support the position that GLP-1 therapy ought to continue for osteoarthritis management even once the weight target has been reached.
If a follow-up study were to examine that question, it would support the position that GLP-1 therapy ought to continue for osteoarthritis management even once the weight target has been reached.
In this research, OA was studied using a mouse model, and the authors suggest that glp1 offers protection by switching on a pathway within chondrocytes. If chondrocytes do carry glp1 receptors, then any medication capable of activating glp1 ought to trigger that same pathway and deliver comparable benefits.
Crumplestiltskin
Explorer
That angle interests me a lot as well. Is the effect more along the lines of an anti-inflammatory action, or is there genuine repair happening?