OBJECTIVES: Obesity is a widespread health concern associated with increased risk of osteoarthritis, a debilitating joint disease. Recently approved anti-obesity medications (AOMs), including tirzepatide (Zepbound) and semaglutide (Wegovy), offer promising avenues for weight management, but their impact on osteoarthritis risk remains unclear. The impact of newly approved AOM use on the risk of osteoarthritis among US patients with obesity was evaluated.

METHODS: Utilizing Kythera data, we conducted a retrospective cohort study from November 2022 to June 2024. Patients with obesity and AOM use were identified based on diagnosis claims and prescription claim(s) for Zepbound or Wegovy (identification period, 11/1/2023-12/31/2023) with 6 months follow-up to measure the risk of osteoarthritis. Patients with AOM use and a diagnosis of osteoarthritis before the identification period were excluded. The risk of osteoarthritis among obesity patients was determined using Cox regression. Results among Zepbound and Wegovy users were also compared. Multivariable analysis was used to control for comorbidities and sociodemographic factors.

RESULTS: We identified 21,819 patients with obesity and AOM use (19,087 Wegovy users, 2,732 Zepbound users); 85,018 patients were included in the non-AOM cohort. Significant differences were observed in the proportions of patients with Elixhauser index score ≥2 (AOM group, 62.95% vs non-AOM group: 15.81%; std. diff=1.2035). AOM users demonstrated significantly lower incidence of osteoarthritis (2.99%) than non-users (14.43%, p<0.0001). Furthermore, the risk-adjusted likelihood of osteoarthritis was 37% lower among patients with obesity using AOMs than those without AOM use (hazard ratio [HR]=0.63, p<0.0001). The incidence of osteoarthritis was slightly lower among Zepbound users (2.42%) than Wegovy users (3.08%) (p=0.0584). However, the risk-adjusted likelihood of osteoarthritis showed no significant difference among Zepbound and Wegovy users (p=0.1126).

CONCLUSIONS: AOM use was associated with a significantly lower risk-adjusted likelihood of osteoarthritis than non-use, highlighting these medications as promising interventions in obesity management.