ArticleAnnals of the rheumatic diseases2023
Glucagon-like peptide-1 receptor agonists as a disease-modifying therapy for knee osteoarthritis mediated by weight loss: findings from the Shanghai Osteoarthritis Cohort.
Article in Annals of the rheumatic diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 5 of them syntheses that pooled it.
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Who cites it
70 citing papers in PubMed, 5 syntheses or guidelines pooled it, 102 citations in OpenAlex.
- GLP-1 Receptor Agonists and Musculoskeletal Outcomes: A Systematic Literature Review and Meta-Analysis.Drugs · 2026Pooled it
- The effect of GLP-1 receptor agonists on osteoarthritis risk in individuals with type 2 diabetes mellitus: a systematic review and network meta-analysis of randomized controlled trials.Acta diabetologica · 2026Pooled it
- Weight regain after cessation of medication for weight management: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2026Pooled it
- Comparative efficacy and safety of antidiabetic drugs for obese patients with knee osteoarthritis: a network meta-analysis of randomized controlled trials.Aging clinical and experimental research · 2025 · on this mapPooled it
- Glucagon-like peptide-1 (GLP-1) receptor agonists for headache and pain disorders: a systematic review.The journal of headache and pain · 2024Pooled it
- If the evidence is there, why are GLP-1 receptor agonists not on-label for hip and knee osteoarthritis in overweight patients?RMD open · 2025Trial
- Multiomics insights into the effects of prebiotics on physical function and metabolism in adults with obesity and knee osteoarthritis.Gut microbes · 2026Article
- Glucagon-like peptide-1: a critical link between gut microbiota dysbiosis and degenerative musculoskeletal diseases.Gut microbes · 2026Review
- Investigating the impact of Glucagon-like peptide-1 therapy on total shoulder arthroplasty outcomes.International orthopaedics · 2026Article
- Endocrine‑metabolic imbalance drives osteoarthritis: From whole‑joint pathobiology to precision therapy (Review).International journal of molecular medicine · 2026Review
- Pandemic-era changes in obesity-associated disabling arthritis burden among United States adults: a repeated cross-sectional study.Clinical rheumatology · 2026Article
- Beyond the Scale: Changes in Pain, Physical Function (WOMAC), and Low-Grade Inflammation Following Semaglutide Treatment in Patients with Knee Osteoarthritis-Results from a Six-Month Real-World Cohort.Journal of clinical medicine · 2026Article
- GLP-1 receptor agonists in osteoarthritis and psoriatic disease: the missing link between obesity and inflammation?Rheumatology international · 2026Review
- Advances in heterogeneity and classification of osteoarthritis.Bone research · 2026Review
- Pathological mechanisms of osteoarthritis in the network of geriatric comorbidities: Emerging insights from organs-crosstalk.Journal of orthopaedic translation · 2026Review
- Peritoneal Incretin Deficiency and Tirzepatide as a Multi-Axis Adjuvant Hypothesis in Treatment-Refractory Endometriosis: A Mechanistic Framework Linking Metabolism, Immunity, Fibrosis, and Nociception.International journal of molecular sciences · 2026Review
- Semaglutide targets muscle mitochondria to regulate glutamine metabolism and treat osteoarthritis.iScience · 2026Article
- The gut-joint axis in osteoarthritis.Nature reviews. Rheumatology · 2026Review
- Perceptions of Glucagon-like Peptide 1 Receptor Agonists Among Individuals With Knee Osteoarthritis and Excess Weight: A Qualitative Study.ACR open rheumatology · 2026Article
- GLP-1 and GIP: Magic bullet for musculoskeletal diseases?Journal of advanced research · 2026Review
10 more citing papers are in PubMed but not listed here.
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveObesity is a risk factor for knee osteoarthritis (KOA) development and progression. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are indicated for type 2 diabetes mellitus (T2DM) and obesity. However, whether KOA patients can benefit from GLP-1RA therapies has not been sufficiently investigated, especially in the long term.
methodsThe Shanghai Osteoarthritis Cohort study is a prospective, observational, multicentre study of >40 000 adults with clinically diagnosed osteoarthritis aged >45 years in Shanghai. We identified all KOA participants with comorbid T2DM enrolled from 1 January 2011 to 1 January 2017. Primary outcome was incidence of knee surgery after enrolment. Secondary outcomes included pain-relieving medication use, number of intra-articular therapies, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and medial femorotibial joint cartilage thickness. To evaluate the effects of GLP-1RA, we performed before-and-after comparison and comparison with participants who had no GLP-1RA exposure.
resultsFor an intergroup comparison (non-GLP-1RA vs GLP-1RA), more weight loss (adjusted mean difference in weight change from baseline -7.29 kg (95% CI -8.07 to -6.50 kg), p<0.001) and lower incidence of knee surgery (93/1574 (5.9%) vs 4/233 (1.7%), adjusted p=0.014) were observed in the GLP-1RA group. Statistically significant differences in mean change from baseline for the WOMAC total and pain subscale scores were observed (adjusted mean difference in WOMAC total score -1.46 (95% CI -2.84 to -0.08), p=0.038; adjusted mean difference in WOMAC pain subscore -3.37 (95% CI -5.79 to -0.94), p=0.007). Cartilage-loss velocity of the medial femorotibial joint was significantly lower in the GLP-1RA group postadjustment for baseline characteristics (adjusted mean difference -0.02 mm (95% CI -0.03 to -0.002 mm), p=0.004). For the before-and-after comparison within the GLP-1RA group, we observed a significant decrease of symptom-relieving medication consumption and cartilage loss velocity of medial femorotibial joint (after-treatment vs before-treatment: -0.03±0.05 vs -0.05±0.07 mm/year, p<0.001). The association between GLP-1RA exposure and decreased incidence of knee surgery was mediated by weight reduction (mediation proportion: 32.1%), instead of glycaemic control (too small to calculate).
conclusionWith sufficient treatment duration, GLP-1RA therapies might be disease-modifying for KOA patients with comorbid T2DM, possibly mediated by weight loss. Further investigation is needed to elucidate effects of GLP-1RA on disease process, joint structure and patient-reported outcomes of osteoarthritis.
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