Научно-практическая ревматология (Sep 2015)
EVALUATION OF THE IMPACT OF DRUG THERAPY FOR OBESITY ON THE CLINICAL MANIFESTATIONS OF KNEE OSTEOARTHRITIS IN OVERWEIGHT WOMEN
Abstract
Objective: to evaluate the impact of orlistat therapy on the clinical manifestations of knee osteoarthritis (OA) in obese patients.Subjects and methods. The investigation enrolled 50 women aged 45–65 years with Kellgren–Lawrence Stages II–III knee OA and obesity [body mass index (BMI) > 30 kg/m2] who were randomized into 2 groups: 1) 25 patients who took Orlistat in a dose of 120 mg (one capsule) thrice daily for 6 months in conjunction with a low-calorie diet and exercise; 2) 25 patients who received only non-drug therapy for obesity (a low-calorie diet and exercise). The investigators assessed anthropometric measures, WOMAC index, and health status using a visual analogue scale.Results and discussion. After 6 months, group 1 had more marked weight loss than group 2: 10.0% (mean 10.5 kg) and 0.8% (mean 1 kg) respectively. Orlistat also provided more pronounced reduction of WOMAC pain scores, functional insufficiency and WOMAC index than non-pharmacological therapy (by 52.2% and 28.8%, р ≤ 0.05, by 51 and 18%, р ≤ 0.05 and by 51 and 19%, p = 0.006 respectively). Moreover, group 1 showed significant improvement of quality of life as compared to group 2 (p < 0.001). The tolerability of Orlistat was good; only two patients reported diarrhea due to dietary errors (fat intake), which required no drug discontinuation.Conclusion. The investigation has demonstrated that body weight loss provided by appropriate medications leads to the regress of clinical manifestations of knee OA in obese patients: pain relief and functional improvement. So drugs contributing to weight los, should be incorporated into treatment regimens for patients with OA and obesity.
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