ASSOCIATION OF SEMAGLUTIDE WITH ORTHOPAEDIC OUTCOMES IN PATIENTS WITH SIGNIFICANT ADIPOSITY AND TYPE 2 DIABETES MELLITUS

The increasing prevalence of diabetes and obesity presents a significant public health challenge. Anti-obesity medications like semaglutide, a GLP-1 receptor agonist (GLP-1RA), have been introduced to combat this issue. Initially approved for Type 2 diabetes mellitus (T2DM) and later for weight management, semaglutide is effective in regulating glucose and suppressing appetite. This study examines the impact of semaglutide on patients with T2DM and significant adiposity undergoing total joint replacements, including shoulder, knee, and hip arthroplasties. This retrospective cohort study utilized data from TriNetX's US Research Network, comprising over 130 million patients across 92 healthcare organizations. Patients with T2DM or significant adiposity who initiated semaglutide or non-GLP-1 receptor agonists between December 2017 and May 2021 or June 2021 and July 2023, respectively, were included. Exclusion criteria included a history of osteoarthritis, other anti-diabetic medications, or bariatric surgery. Propensity score matching balanced demographic variables and comorbidities across cohorts. Outcomes assessed included joint pain, osteoarthritis, BMI ≥ 30 kg/m², mortality, and total joint arthroplasties. The study included 541,803 patients with T2DM and 70,082 with significant adiposity. The semaglutide cohort showed higher rates of joint pain, new-onset osteoarthritis, and BMI ≥ 30 kg/m², with lower mortality rates. However, there were no significant differences in total joint arthroplasties between cohorts. Semaglutide effectively manages weight and reduces mortality but is associated with increased joint pain and new-onset osteoarthritis. Nevertheless, no significant rise in total joint arthroplasties was observed, warranting further investigation into long-term effects.