Glucagon-like peptide-1 receptor agonists therapy to attenuate the risk of knee osteoarthritis and total knee replacement in type 2 diabetes mellitus: A nation-wide population-based cohort study

📖 Top 50% JournalFeb 10, 2025Medicine

Glucagon-like peptide-1 treatment linked to lower risk of knee osteoarthritis and knee replacement in people with type 2 diabetes

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Abstract

Among 35,762 patients with type 2 diabetes mellitus, treatment with is associated with a lower risk of and .

Patients with type 2 diabetes who received glucagon-like peptide-1 receptor agonists had a lower incidence of knee osteoarthritis compared to those who did not.
The rate of total knee replacement in patients with knee osteoarthritis was also reduced among those treated with glucagon-like peptide-1 receptor agonists.
Cox proportional hazard analysis indicated a significant reduction in the risk of knee osteoarthritis and total knee replacement for patients receiving glucagon-like peptide-1 receptor agonists.
Kaplan-Meier analysis revealed a significant difference in cumulative risk of knee osteoarthritis and total knee replacement between patients treated and not treated with glucagon-like peptide-1 receptor agonists.

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Type 2 diabetes mellitus (T2DM) is an independent risk factor of (KOA). This study was mainly based on data from the Taiwan National Health Insurance Database. Using big data analysis, we showed that glucagon-like peptide-1 receptor agonist (GLP-1RA) treatment is helpful for patients with T2DM who have a lower risk of KOA or (TKR). A total of 35,762 patients with T2DM were included in this study. We divided these patients into 988 patients with T2DM without KOA and 372 patients with T2DM with KOA who received GLP-1RA treatment and those who did not receive GLP-1RA treatment. The patients were matched for sex, age, and inclusion date by 1:1 propensity score, which was included in the control group. Cox proportional hazards analyses were performed to compare KOA risk and TKR rate during a maximum follow-up period of 5 years. There were 1976/744 patients with T2DM without/with KOA who received and did not receive GLP-1RA treatment, including 1052/322 men (53.24/43.28%) and 924/422 women (46.76/56.72%). At the end of follow-up, there were 46/39 (4.66/10.48%) patients with T2DM without/with KOA who received GLP-1RA treatment and underwent KOA/TKR were lower than those without GLP-1RA treatment 87/70 (8.81/18.82%). Cox proportional hazard regression analysis showed a lower rate of KOA/TKR among patients with GLP-1RA treatment (adjusted hazard ratio [HR] = .852; 95% confidence interval [CI] = .784-.930, P < .001/ adjusted HR = .913; 95% CI = .885-.977, P = .015, respectively). Kaplan-Meier analysis showed that the cumulative risk of KOA/TKR in patient with/without GLP-1RA was significantly different (log-rank test, P < .001/P < .001, respectively). This study aimed to provide clinicians with the option of GLP-1RA as a treatment for patients with T2DM with or without KOA to reduce the risk of KOA or TKR among such patients.

Key numbers

14.8%

Decrease in Risk

Risk reduction in patients with treated with compared to those untreated.

8.7%

Decrease in Risk

Risk reduction in patients with treated with compared to those untreated.

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Abstract

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