Patients with Osteoarthritis Show Improvements after Weight Loss

Massive weight loss due to bariatric surgery could greatly improve the quality of life for osteoarthritis patients, according to a small pilot study.

​Approximately 27 million Americans have osteoarthritis, a condition of significant public health concern because it directly impacts an affected adult’s functioning. There have been no new treatments within the past two decades, and the most effective therapy remains joint replacement.[[{"type":"media","view_mode":"media_crop","fid":"43648","attributes":{"alt":"©CLIPAREACustommedia/Shutterstock.com","class":"media-image media-image-right","id":"media_crop_2621037242934","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4803","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"font-size: 13.008px; line-height: 1.538em; float: right;","title":"","typeof":"foaf:Image"}}]]

In a presentation given on Nov. 8 at the 2015 ACR/ARHP annual meeting in San Francisco, Calif., Cleveland Clinic rheumatologist and immunologist Elaine Husni, MD, discussed the impact of significant weight loss on quality of life, presenting the surgery as a potential strategy for osteoarthritis-symptom reduction. Recent research indicates fat cells could be metabolically active, contributing to inflammatory cytokine development.

“We wanted to see if massive weight loss in patients with osteoarthritis would make a difference beyond reducing the mechanical load on joints,” she said.

Three years post-bariatric surgery, she said, osteoarthritis patients reported, using the SF-36 self-assessment health survey, greater positive feelings about their overall health than those who didn’t undergo surgery. Patients did, however, during the same time, lose some walking and stair-climbing stamina.

Of the 67 study participants, 49 underwent surgery and 18 received medical intervention alone, such as calorie reduction, behavioral modification, or lifestyle changes. Individuals either had physician-documented osteoarthritis; radiographic evidence of degenerative changes in the hip, knee, ankle, foot, or spine; or they met the American College of Rheumatology’s criteria for knee or hip osteoarthritis.

The pilot study is part of the larger STAMPEDE trial – a randomized, controlled trial, evaluating the efficacy of medical therapy alone versus medical therapy combined with bariatric surgery in patients with uncontrolled Type 2 diabetes.

Additional study into activity level, weight-loss maintenance, and metabolic cytokines is needed to understand how to maintain bariatric-surgery impact, she said.

Disclosures:

This pilot study received funding support through The Cleveland Clinic.

References:

“Effects of Bariatric Surgery on Long-Term Quality of Life Outcomes for Obese Patients with Osteoarthritis,” Elaine Husni, MD, Nov. 8, 2015, 9 a.m. - 11 a.m. session