Background Osteoarthritis is an important social and medical problem. Obesity is an main modifiable risk factor for the development and progression of knee osteoarthritis.
Objectives The aim of the study is to evaluate the influence of weight reduction on clinical symptoms and quality of life of patients with knee osteoarthritis.
Methods The study included 50 women, aged 45-65 years with knee osteoarthritis stage II-III Kellgren-Lawrence and obesity (body mass index (BMI) >30kg/cm2). Control group consisted of 23 women aged 48 to 65 years with knee osteoarthritis and BMI<30kg/cm2. Obese patients were randomized into 2 groups. 1st group (25 patients) took orlistat a dose of 120 mg (1 tablet) 3 times daily for 6 months in combination with a low-calorie diet and physical activity. 2 group (25 patients) - non-pharmacological therapy of obesity (hypocaloric diet and physical activity). Patients in both groups received standard treatment regimen osteoarthritis. Functional index WOMAC, quality of life according to VAS were evaluated.
Results Comparison of osteoarthritis patients with obesity (BMI>30kg/cm2) and without (BMI<30kg/cm2) revealed that although patients with overweight were slightly younger (mean age 55,6±5,3 and 58,7±5,4 years) and had a shorter duration of the disease (7±3,7 years and 9,3±4,1 years, respectively), but they had more severe osteoarthritis: in obesity knee osteoarthritis stage III was more frequently detected (11.4% vs4,3%), a significantly higher index WOMAC (p<0,05). Weight reduction was more signified in the group of patients on orlistat therapy by 9,05% (average 9,5 kg), compared with patients who were only on a hypocaloric diet where the weight has decreased by 2,54% (average 2,66 kg). WOMAC pain for patients who are on orlistat therapy decreased by 48.7% and was significantly lower (p=0,012) than in the 2 group, where the rate declined by only 32,2%. Similar changes were observed in functional failure: the dynamics of this index in the 1st group was significantly lower than in the 2 group (p=0,004) (a decrease of 49,75% and 32,77%, respectively). After 6 months against the background of the weight reduction the total index WOMAC decreased in both groups (at 49,31% and 32,9% respectively), but was significantly lower in the group treated with orlistat (p=0,006). Moreover, in this group revealed a significant improvement of life quality compared with those with a smaller weight loss (p<0,001). Tolerability of orlistat was good, only two patients reported adverse reactions like liquid stool against the background of errors in the diet (fatty meal).
Conclusions Our study demonstrated that weight loss, especially while taking drugs that reduce weight by obese patients with knee osteoarthritis leads to a reduction in the clinical developments of knee osteoarthritis: relieve pain and improve the functional state of the knee. In this connection, drugs that affect the weight loss should be included in the treatment regimen of patients with osteoarthritis and obesity.
Disclosure of Interest : None declared