Greater risk reductions seen with new-generation agents and with longer duration of use
WEDNESDAY, June 10, 2026 (HealthDay News) — For patients with knee osteoarthritis (OA), glucagon-like peptide-1 receptor agonist (GLP-1 RA) use is associated with a reduced long-term risk for total knee arthroplasty (TKA), according to a study published online June 2 in Regional Anesthesia & Pain Medicine.
Victoria Carter, from the University of Maryland School of Medicine in Baltimore, and colleagues conducted a retrospective cohort study involving adults with knee OA diagnosed between Jan. 1, 2010, and Dec. 31, 2024, to examine whether GLP-1 RAs can reduce progression to TKA. Patients were stratified by GLP-1 RA exposure class (any GLP-1 RA or new-generation agents) and treatment duration (one or three years) and were compared to propensity score-matched nonexposed cohorts.
The cohort sizes ranged from 13,351 patients (new-generation GLP-1 RA, three-year exposure) to 42,062 patients (any GLP-1 RA, one-year exposure) after propensity score matching. The researchers found that across all exposure classes, durations, and follow-up intervals, GLP-1 RA use was associated with significantly lower cumulative TKA incidence. The absolute risk difference at eight years was –2.80 percentage points with one-year exposure to any GLP-1 RA. Greater risk reductions were seen with new-generation agents and longer duration; there was an absolute risk difference of –4.71 percentage points at eight years associated with three-year exposure to semaglutide or tirzepatide (hazard ratio, 0.72).
“Clinically, these findings indicate that GLP-1 RAs may represent a complementary strategy within nonsurgical knee OA management, particularly in metabolically high-risk patients,” the authors write.
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