Background Obesity and knee osteoarthritis (OA) are among the most frequent chronic conditions.
Objectives To evaluate the impact of body weight loss on the clinical manifestations of knee OA, quality of life, parameters of metabolic syndrome (level of blood pressure (BP), blood lipids, blood glucose, body mass index (BMI), waist circumference (WC), hip circumference (HC) in women with knee OA and obesity, taking orlistat.
Methods The study included 50 women, aged 45-65 years, with knee OA stage II-III by Kellgren-Lawrence and obesity (BMI>30 kg/m2). Patients were randomized into 2 groups. Patients from group 1 (n=25) were taking orlistat 120 mg (1 capsule) 3 times a day during 6 months alongside with low calorie diet and exercise. Weight loss interventions in group 2 (n=25) were limited only to low calorie intake and physical exercise. The following parameters were monitored during 6 months on a monthly basis: anthropometric (BMI, WC, HC), BP, blood biochemistry panel (lipid profile and glucose level), functional index WOMAC and health related quality of life based on EQ-5D questionnaire.
Results Weight loss in patients taking orlistat was 10,07% (mean 10,4kg). Proportion of patients losing ≥5% of body mass from baseline was 44% (11 patients), 56% (14 patients) lost >10% of body mass compared to baseline. In patients from group 2 mean weight loss was 1% (mean 1 kg). Considerable reduction of WC (-8,3cm) and HC (-5,28cm) was documented in patients taking orlistat as compared to patients on diet only (p<0,05). Pain intensity (WOMAC scale) in patients from group 1 reduced by 52%, which was significantly more (p<0,05), than in the group 2 demonstrating only 20% reduction. Similar trend was registered in functional impairment scale: repeated evaluations showed consistent improvement to a greater extent in group 1 as compared to group 2 (p<0,05) (by 51% and 18%, respectively). Summarized WOMAC index decreased in both groups after weight loss (by 51,49% and 19% respectively), but was statistically significantly lower in orlistat group (p=0,006). Besides weight loss was associated with improvement of knee OA, and thus, with the improvement of health related quality of life, more evident in group 1 with greater weight loss - EQ-5D (0,24) as compared to group 2 (0) (p<0,001). There were no statistically significant deviations from baseline in BP, glucose, total cholesterol, HDL, LDL, and triglycerides levels in both groups. Orlistat tolerability was good, only 2 patients had adverse drug reactions – diarrhea (following diet violation, i.e. intake of fatty food), not requiring discontinuation of the drug.
Conclusions Results of this study demonstrate that weight loss only by 10% in patients with obesity and knee OA thanks to orlistat resulted in significant improvement of clinical manifestations of knee OA: reduction of pain intensity and improvement of knee function. Weight loss and improvement of knee OA manifestations also favors the improvement of health related quality of life based on EQ-5D questionnaire, thus weight loss therapy should be considered in management of obese OA patients.
Disclosure of Interest None declared