Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients: A twelve-month randomized controlled trial

Robin Christensen; Marius Henriksen; Anthony R Leeds; Henrik Gudbergsen; Pia Christensen; Tina J Sørensen; Else Marie Bartels; Birgit F Riecke; Jens Aaboe; Rikke Frederiksen; Mikael Boesen; L Stefan Lohmander; Arne Astrup; Henning Bliddal

doi:10.1002/acr.22504

Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients: A twelve-month randomized controlled trial

Robin Christensen, Marius Henriksen, Anthony R Leeds, Henrik Gudbergsen, Pia Christensen, Tina J Sørensen, Else Marie Bartels, Birgit F Riecke, Jens Aaboe, Rikke Frederiksen, Mikael Boesen, L Stefan Lohmander, Arne Astrup, Henning Bliddal

62 Citations (Scopus)

Abstract

Objective To compare results of obese patients with knee osteoarthritis (OA) who, after an intensive weight loss regimen, received 1 year of either dietary support (D), a knee-exercise program (E), or "no attention" (C; control group). Methods We conducted a randomized, 2-phase, parallel-group trial. A total of 192 obese participants with knee OA were enrolled; the mean age was 62.5 years and 81% were women with a mean entry weight of 103.2 kg. In phase 1, all participants were randomly assigned to 1 of 3 groups and began a dietary regimen of 400-810 and 1,250 kcal/day for 16 weeks (2 8-week phases) to achieve a major weight loss. Phase 2 consisted of 52 weeks' maintenance in either group D, E, or C. Outcomes were changes from randomization in pain on a 100-mm visual analog scale, weight, and response according to the Outcome Measures in Rheumatology-Osteoarthritis Research Society International criteria. Results Mean weight loss for phase 1 was 12.8 kg. After 1 year on maintenance therapy, the D group sustained a lower weight (11.0 kg, 95% confidence interval [95% CI] 9.0, 12.8 kg) than those in the E (6.2, 95% CI 4.4, 8.1 kg) and C (8.2, 95% CI 6.4, 10.1 kg) groups (P = 0.002 by analysis of covariance [ANCOVA]). Adherence was low in the E group. All groups had statistically significant pain reduction (D: 6.1; E: 5.6; and C: 5.5 mm) with no difference between groups (P = 0.98 by ANCOVA). In each group 32 (50%), 26 (41%), and 33 (52%) participants responded to treatment in the D, E, and C groups, respectively, with no statistically significant difference in the number of responders (P = 0.41). Conclusion A significant weight reduction with a 1-year maintenance program improves knee OA symptoms irrespective of maintenance program.

Original language	English
Journal	Arthritis Care & Research
Volume	67
Issue number	5
Pages (from-to)	640-650
Number of pages	11
ISSN	2151-464X
DOIs	https://doi.org/10.1002/acr.22504
Publication status	Published - 1 May 2015

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Christensen, R., Henriksen, M., Leeds, A. R., Gudbergsen, H., Christensen, P., Sørensen, T. J., Bartels, E. M., Riecke, B. F., Aaboe, J., Frederiksen, R., Boesen, M., Lohmander, L. S., Astrup, A., & Bliddal, H. (2015). Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients: A twelve-month randomized controlled trial. Arthritis Care & Research, 67(5), 640-650. https://doi.org/10.1002/acr.22504

Christensen, R, Henriksen, M, Leeds, AR, Gudbergsen, H, Christensen, P, Sørensen, TJ, Bartels, EM, Riecke, BF, Aaboe, J, Frederiksen, R, Boesen, M, Lohmander, LS, Astrup, A & Bliddal, H 2015, 'Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients: A twelve-month randomized controlled trial', Arthritis Care & Research, vol. 67, no. 5, pp. 640-650. https://doi.org/10.1002/acr.22504

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title = "Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients: A twelve-month randomized controlled trial",

abstract = "Objective To compare results of obese patients with knee osteoarthritis (OA) who, after an intensive weight loss regimen, received 1 year of either dietary support (D), a knee-exercise program (E), or {"}no attention{"} (C; control group). Methods We conducted a randomized, 2-phase, parallel-group trial. A total of 192 obese participants with knee OA were enrolled; the mean age was 62.5 years and 81% were women with a mean entry weight of 103.2 kg. In phase 1, all participants were randomly assigned to 1 of 3 groups and began a dietary regimen of 400-810 and 1,250 kcal/day for 16 weeks (2 8-week phases) to achieve a major weight loss. Phase 2 consisted of 52 weeks' maintenance in either group D, E, or C. Outcomes were changes from randomization in pain on a 100-mm visual analog scale, weight, and response according to the Outcome Measures in Rheumatology-Osteoarthritis Research Society International criteria. Results Mean weight loss for phase 1 was 12.8 kg. After 1 year on maintenance therapy, the D group sustained a lower weight (11.0 kg, 95% confidence interval [95% CI] 9.0, 12.8 kg) than those in the E (6.2, 95% CI 4.4, 8.1 kg) and C (8.2, 95% CI 6.4, 10.1 kg) groups (P = 0.002 by analysis of covariance [ANCOVA]). Adherence was low in the E group. All groups had statistically significant pain reduction (D: 6.1; E: 5.6; and C: 5.5 mm) with no difference between groups (P = 0.98 by ANCOVA). In each group 32 (50%), 26 (41%), and 33 (52%) participants responded to treatment in the D, E, and C groups, respectively, with no statistically significant difference in the number of responders (P = 0.41). Conclusion A significant weight reduction with a 1-year maintenance program improves knee OA symptoms irrespective of maintenance program.",

author = "Robin Christensen and Marius Henriksen and Leeds, {Anthony R} and Henrik Gudbergsen and Pia Christensen and S{\o}rensen, {Tina J} and Bartels, {Else Marie} and Riecke, {Birgit F} and Jens Aaboe and Rikke Frederiksen and Mikael Boesen and Lohmander, {L Stefan} and Arne Astrup and Henning Bliddal",

note = "CURIS 2015 NEXS 181",

year = "2015",

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day = "1",

doi = "10.1002/acr.22504",

language = "English",

volume = "67",

pages = "640--650",

journal = "Arthritis Care & Research",

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TY - JOUR

T1 - Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients

T2 - A twelve-month randomized controlled trial

AU - Christensen, Robin

AU - Henriksen, Marius

AU - Leeds, Anthony R

AU - Gudbergsen, Henrik

AU - Christensen, Pia

AU - Sørensen, Tina J

AU - Bartels, Else Marie

AU - Riecke, Birgit F

AU - Aaboe, Jens

AU - Frederiksen, Rikke

AU - Boesen, Mikael

AU - Lohmander, L Stefan

AU - Astrup, Arne

AU - Bliddal, Henning

N1 - CURIS 2015 NEXS 181

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Objective To compare results of obese patients with knee osteoarthritis (OA) who, after an intensive weight loss regimen, received 1 year of either dietary support (D), a knee-exercise program (E), or "no attention" (C; control group). Methods We conducted a randomized, 2-phase, parallel-group trial. A total of 192 obese participants with knee OA were enrolled; the mean age was 62.5 years and 81% were women with a mean entry weight of 103.2 kg. In phase 1, all participants were randomly assigned to 1 of 3 groups and began a dietary regimen of 400-810 and 1,250 kcal/day for 16 weeks (2 8-week phases) to achieve a major weight loss. Phase 2 consisted of 52 weeks' maintenance in either group D, E, or C. Outcomes were changes from randomization in pain on a 100-mm visual analog scale, weight, and response according to the Outcome Measures in Rheumatology-Osteoarthritis Research Society International criteria. Results Mean weight loss for phase 1 was 12.8 kg. After 1 year on maintenance therapy, the D group sustained a lower weight (11.0 kg, 95% confidence interval [95% CI] 9.0, 12.8 kg) than those in the E (6.2, 95% CI 4.4, 8.1 kg) and C (8.2, 95% CI 6.4, 10.1 kg) groups (P = 0.002 by analysis of covariance [ANCOVA]). Adherence was low in the E group. All groups had statistically significant pain reduction (D: 6.1; E: 5.6; and C: 5.5 mm) with no difference between groups (P = 0.98 by ANCOVA). In each group 32 (50%), 26 (41%), and 33 (52%) participants responded to treatment in the D, E, and C groups, respectively, with no statistically significant difference in the number of responders (P = 0.41). Conclusion A significant weight reduction with a 1-year maintenance program improves knee OA symptoms irrespective of maintenance program.

AB - Objective To compare results of obese patients with knee osteoarthritis (OA) who, after an intensive weight loss regimen, received 1 year of either dietary support (D), a knee-exercise program (E), or "no attention" (C; control group). Methods We conducted a randomized, 2-phase, parallel-group trial. A total of 192 obese participants with knee OA were enrolled; the mean age was 62.5 years and 81% were women with a mean entry weight of 103.2 kg. In phase 1, all participants were randomly assigned to 1 of 3 groups and began a dietary regimen of 400-810 and 1,250 kcal/day for 16 weeks (2 8-week phases) to achieve a major weight loss. Phase 2 consisted of 52 weeks' maintenance in either group D, E, or C. Outcomes were changes from randomization in pain on a 100-mm visual analog scale, weight, and response according to the Outcome Measures in Rheumatology-Osteoarthritis Research Society International criteria. Results Mean weight loss for phase 1 was 12.8 kg. After 1 year on maintenance therapy, the D group sustained a lower weight (11.0 kg, 95% confidence interval [95% CI] 9.0, 12.8 kg) than those in the E (6.2, 95% CI 4.4, 8.1 kg) and C (8.2, 95% CI 6.4, 10.1 kg) groups (P = 0.002 by analysis of covariance [ANCOVA]). Adherence was low in the E group. All groups had statistically significant pain reduction (D: 6.1; E: 5.6; and C: 5.5 mm) with no difference between groups (P = 0.98 by ANCOVA). In each group 32 (50%), 26 (41%), and 33 (52%) participants responded to treatment in the D, E, and C groups, respectively, with no statistically significant difference in the number of responders (P = 0.41). Conclusion A significant weight reduction with a 1-year maintenance program improves knee OA symptoms irrespective of maintenance program.

U2 - 10.1002/acr.22504

DO - 10.1002/acr.22504

M3 - Journal article

C2 - 25370359

SN - 2151-464X

VL - 67

SP - 640

EP - 650

JO - Arthritis Care & Research

JF - Arthritis Care & Research

IS - 5

ER -

Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients: A twelve-month randomized controlled trial

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