OP0030 SUSTAINED WEIGHT LOSS AS TREATMENT OF KNEE OSTEOARTHRITIS IN OBESE PATIENTS: LONG-TERM RESULTS FROM A RANDOMISED TRIAL
R. Christensen, A. Astrup, H. Bliddal

Knee osteoarthritis (OA) can be a painful and disabling disease with no proven disease modifying therapies available. Often, overweight and obese individuals are affected. A study by Bartlett et al presented at the 2004 American College of Rheumatology meeting suggested that even small weight losses from exercise can be associated with significant improvements in pain, stiffness, and function. In this abstract, Christensen et al assess the efficacy of diet-induced weight loss after one year of intervention.

Obese patients (89% female) with a mean BMI of 36, mean age of 63, and a mean WOMAC score of 936 mm were randomized to 1 of 2 intervention groups:
Group I intensive dietary treatment with weekly tutoring in good dietetic practices
Group C received dietetic counseling at weeks 0, 8, 32, 36, and 52
Weight loss and WOMAC scores were obtained.

Results: The table below shows the results looking at the difference between baseline and 1 year of intervention data for each group.

Conclusion: Small, sustained weight loss (8%) in obese patients can result in significant improvements in symptoms of knee OA.

Editorial Comments: There is growing evidence to support the recommendation that weight loss is recommended for patients with osteoarthritis. This study follows on similar results presented last year at ACR showing a clinically meaningful improvement in signs and symptoms and reduction of knee OA symptoms with weight loss. Importantly, the current study demonstrated that providing ongoing intensive tutoring in addition to a recommendation for weight loss resulted in more patients achieving weight loss goals. This study confirms that the amount of weight loss correlates with the degree of symptom improvement.

A recent article by Meissier et al (Arthritis Rheum 2005, 52: 2026-2032) demonstrated a four fold reduction of load exerted on the knee per step for every pound of weight lost. This emerging body of data indicates that obesity is an important modifiable factor in osteoarthritis. Defining the best multidisciplinary approaches to achieving meaningful weight reduction for patients with OA is clearly a critical need in managing patients. That the magnitude of improvement in symptoms in response to weight loss may approach or surpass the relief provided by analgesics and anti-inflammatory medications further demonstrates the importance of developing effective strategies to achieve sustained weight loss in OA patients.

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