Issue: March 2024
Fact checked byShenaz Bagha

Read more

January 23, 2024
2 min read
Save

Mortality risk falls in patients with osteoarthritis who gradually lose weight

Issue: March 2024
Fact checked byShenaz Bagha
You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Key takeaways:

  • Slow-to-moderate weight loss via anti-obesity drugs was associated with lower all-cause mortality in patients with knee or hip osteoarthritis.
  • A fast rate of weight loss showed no difference from stable weight or weight gain.
Perspective from Patricia Happel, DO

The risk for all-cause mortality decreases among patients with knee or hip osteoarthritis who achieve slow-to-moderate, but not fast, weight loss via anti-obesity medications, according to data published in Arthritis & Rheumatology.

Overweight and obesity is an important risk factor for OA,” Jie Wei, PhD, of Xiangya Hospital and the Xiangya School of Public Health, Central South University, in Changsha, China, and colleagues wrote. “Previous studies have found a significant dose-response relationship between the percentage of weight loss and improvement of pain and function in patients with knee OA. There is consensus among international guidelines that weight loss is one of the core treatments for patients with knee and/or hip OA who are overweight or obese.

Obesity_231913452
The risk for all-cause mortality decreases among patients with knee or hip OA who achieve slow-to-moderate, but not fast, weight loss via anti-obesity medications, according to data.
Image: Adobe Stock

“To date, there is a paucity of data on all-cause mortality according to the rate of weight loss among patients with overweight or obesity and knee or hip OA,” they added.

To analyze how the rate of weight loss induced by anti-obesity drugs impacts all-cause mortality in overweight or obese patients with knee or hip OA, Wei and colleagues studied electronic health record data from the U.K.-based IQVIA Medical Research Database. The researchers emulated a targeted, randomized controlled trial using a cloning, censoring and weighting approach. Their analysis included 6,524 patients with hip or knee OA aged between 40 and 90 years. All included patients were either overweight or had obesity, and had experienced at least 1 year of continuous enrollment with general practitioners.

Jie Wei

During the study, 5,916 included patients began taking orlistat, 488 initiated sibutramine (Merida, Abbott) and 120 initiated rimonabant (Acomplia, Sanofi-Aventis). The researchers compared patients’ baseline weight to their weight after 1 year of medication and categorized the rate of each patient’s weight loss as fast (greater than 10%), slow-to-moderate (between 2% and 10%), or stable/gaining weight.

According to the researchers, the all-cause mortality rates among patients with stable/weight gain, slow-to-moderate weight loss, and fast weight loss were 5.3%, 4%, and 5.4%, respectively. Compared with patients in the stable/weight gain group, HRs for all-cause mortality were 0.72 (95% CI, 0.56-0.92) for those who achieved slow-to-moderate weight loss, and 0.99 (95% CI, 0.67-1.44) for those who logged rapid weight loss. In addition, the researchers reported dose-response protective effects of weight loss on incident hypertension, type 2 diabetes and venous thromboembolism.

“Our results provide empirical evidence that a slow to moderate rate of weight loss induced by anti-obesity medications within 1 year lowers all-cause mortality,” Wei and colleagues wrote. “The rate of weight loss is consistent with the guidelines worldwide that gradual weight loss should be recommended for the treatment of obesity.

“Orlistat, accounting for the majority of anti-obesity medications in the current study, has been available for treating obesity for two decades and has a good safety profile,” they added. “Our finding that gradual weight loss by anti-obesity medications lowers all-cause mortality, if confirmed by future studies, could guide policymaking and improve the wellbeing of patients with overweight or obesity and knee or hip OA.”