Scientific deep-dive
GLP-1 for Knee Osteoarthritis: STEP-9 Evidence + Surgery Bridge
STEP-9 (Bliddal 2024 NEJM) showed semaglutide reduced WOMAC pain scores in knee OA patients with obesity. We review the trial outcomes, the joint-replacement bridge, and the practical orthopedic + obesity medicine pathway.
By Eli Marsden · Founding Editor
Editorially reviewed (not clinically reviewed) · How we verify contentLast reviewed
11 min read·9 citations
Knee osteoarthritis affects roughly 14 million US adults. STEP-9 (Bliddal 2024 NEJM) is the first phase-3 randomized trial showing semaglutide 2.4 mg reduces WOMAC pain in patients with both obesity and symptomatic knee osteoarthritis.
References
- 1.Bliddal H, Bays H, Czernichow S, Uddén Hemmingsson J, Hjelmesæth J, et al. Once-Weekly Semaglutide in Persons with Obesity and Knee Osteoarthritis. N Engl J Med. 2024. PMID: 39476339.
- 2.Messier SP, Mihalko SL, Legault C, Miller GD, Nicklas BJ, et al. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial. JAMA. 2013. PMID: 24065013.
- 3.Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019. PMID: 31278997.
- 4.de Ree RHGM, de Jong LD, Hazebroek EJ, Somford MP. Optimal timing of hip and knee arthroplasty after bariatric surgery: A systematic review. J Clin Orthop Trauma. 2024. PMID: 38766387.
- 5.Dunlop DD, Song J, Hootman JM, Nevitt MC, Semanik PA, et al. One Hour a Week: Moving to Prevent Disability in Adults With Lower Extremity Joint Symptoms. Am J Prev Med. 2019. PMID: 30902564.
- 6.Murphy LB, Cisternas MG, Theis KA, Brady TJ, Bohm MK. All-Cause Opioid Prescriptions Dispensed: The Outsized Role of Adults With Arthritis. Am J Prev Med. 2020. PMID: 32763134.
- 7.Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, et al.; SURMOUNT-1 Investigators. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022. PMID: 35658024.
- 8.Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, et al.; STEP 1 Study Group. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021. PMID: 33567185.
- 9.Cava E, Yeat NC, Mittendorfer B. Preserving Healthy Muscle during Weight Loss. Adv Nutr. 2017. PMID: 28507015.