Intentional Weight Loss in Overweight and Obese Patients With Knee Osteoarthritis: Is More Better?
Stephen P. Messier,Allison E. Resnik,Daniel P. Beavers,Shannon L. Mihalko,Gary D. Miller,Barbara J. Nicklas,Paul DeVita,David J. Hunter,Mary F. Lyles,Felix Eckstein,Ali Guermazi,Richard F. Loeser +11 more
TLDR
To determine the dose response effect of weight loss on clinical and mechanistic outcomes in overweight and obese adults with knee osteoarthritis, a large number of subjects were obese or severely overweight.Abstract:
OBJECTIVE To determine the dose response effect of weight loss on clinical and mechanistic outcomes in overweight and obese adults with knee osteoarthritis (OA). METHODS This is a secondary analysis of the diet-induced weight loss only (D) and diet-induced weight loss plus exercise (D + E) groups in the Intensive Diet and Exercise for Arthritis randomized controlled clinical trial. The 240 participants were overweight and obese older community-dwelling adults with pain and radiographic knee OA. Participants were assigned to 1 of 4 groups according to weight loss achieved over an 18-month period: 20% (≥20% group). RESULTS There were significant dose responses to weight loss for pain (P = 0.01), function (P = 0.0006), 6-minute walk distance (P < 0.0001), physical (P = 0.0004) and mental (P = 0.03) health-related quality of life (HRQoL), knee joint compressive force (P < 0.0001), and interleukin-6 (P = 0.002). Greater weight loss resulted in superior clinical and mechanstic outcomes, with the highest weight loss group (≥20% group) distinguishing itself on all measures compared with the <5% and ≥5% groups; the ≥20% group had 25% less pain and better function compared with the ≥10% group and significantly (P = 0.006) better physical HRQoL. CONCLUSION Long-term weight loss of 10-19.9% of baseline body weight has substantial clinical and mechanistic benefits compared with less weight loss. The value of an additional 10% weight loss includes significantly improved physical HRQoL and a clinically important reduction of pain and improvement in function.read more
Citations
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2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee
Sharon L. Kolasinski,Tuhina Neogi,Marc C. Hochberg,Carol A. Oatis,Gordon Guyatt,Joel A. Block,Leigh F. Callahan,Cindy Copenhaver,Carole Dodge,David T. Felson,Kathleen Gellar,William F. Harvey,Gillian A. Hawker,Edward Herzig,C. Kent Kwoh,Amanda E. Nelson,Jonathan Samuels,Carla R. Scanzello,Daniel K. White,Barton L Wise,Roy D. Altman,Dana DiRenzo,Joann Fontanarosa,Gina Giradi,Mariko L. Ishimori,Devyani Misra,Amit Aakash Shah,Anna Shmagel,Louise M. Thoma,Marat Turgunbaev,Amy S. Turner,James Reston +31 more
TL;DR: An evidence‐based guideline for the comprehensive management of osteoarthritis (OA) is developed as a collaboration between the American College of Rheumatology and the Arthritis Foundation, updating the 2012 ACR recommendations for the management of hand, hip, and knee OA.
Journal ArticleDOI
An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO)
Olivier Bruyère,Germain Honvo,Nicola Veronese,Nigel K Arden,Jaime Branco,Elizabeth M Curtis,Nasser M. Al-Daghri,Gabriel Herrero-Beaumont,Johanne Martel-Pelletier,Jean-Pierre Pelletier,François Rannou,René Rizzoli,Roland Roth,Daniel Uebelhart,Cyrus Cooper,Jean-Yves Reginster +15 more
TL;DR: The updated ESCEO stepwise algorithm, developed by consensus from clinical experts in OA and informed by available evidence for the benefits and harms of various treatments, provides practical, current guidance that will enable clinicians to deliver patient-centric care in Oa practice.
Journal ArticleDOI
Modifiable risk factors in knee osteoarthritis: treatment implications
TL;DR: The objectives of the present narrative review were to identify, summarize, and cluster all the potentially modifiable risk factors that influence the course of KOA, and discuss their susceptibility to alteration via personal, clinical, and public strategy.
Journal ArticleDOI
Weight loss and risk reduction of obesity-related outcomes in 0.5 million people: evidence from a UK primary care database
Christiane L Haase,Sandra Lopes,Anne Helene Olsen,Altynai Satylganova,Volker Schnecke,Phil McEwan +5 more
TL;DR: In this article, the effect of weight loss on 10 selected outcomes in a population from the UK Clinical Practice Research Datalink (CPRD) GOLD database was examined, with the greatest benefits observed for the established CVD risk factors T2D, hypertension and dyslipidaemia.
Journal ArticleDOI
Core and adjunctive interventions for osteoarthritis: efficacy and models for implementation.
J L Bowden,David J. Hunter,Leticia A Deveza,Vicky Duong,Krysia Dziedzic,Kelli D. Allen,Ping Keung Chan,Jillian P Eyles +7 more
TL;DR: The core priority treatments for OA, including exercise and physical activity, weight-loss, education and support for self-management are discussed, including physical or psychological evidence-based adjunctive therapies and combined therapies that can be used to tailor individual programmes.
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