A new study has shown that the popular GLP-1 weight loss drug semaglutide has the power to halt, and to some extent restore, cartilage in people suffering from osteoarthritis (OA). The finding hints at a possible use of the drug beyond weight loss.
In 2017, America’s Food and Drug Administration approved the drug semaglutide for treating diabetes. In 2021 the FDA also approved it as a weight loss aid. Since then, some studies have hinted that the drug – sold popularly as Ozempic, Wegovy, and Rybelsus – might have effectiveness treating a variety of other conditions.
For example, the FLOW trial in 2024 showed that the drug reduced the risk of kidney failure and death from cardiovascular causes in patients with type 2 diabetes and chronic kidney disease. Another 2024 study showed that the drug positively impacted motor activity in Parkinson’s patients and helped ward off brain shrinkage and cognitive decline in Alzheimer’s patients, although a follow-up study has brought these results into question.
Now, researchers from China have conducted a study that shows another possible off-label use of semaglutide: arthritis prevention.
In the study, which used both humans and mice, the research team first divided obese rodents with arthritis into two groups. One group was given semaglutide, which reduced their appetites. The second group was not given the drug, but was fed exactly the same amount of food eaten by the semaglutide group. This caused the mice in both groups to lose the same amount of weight. It also allowed the researchers to test for the drug’s effect beyond weight loss.
The team found that only the mice on semaglutide showed reduced cartilage breakdown as well as a reduction in bone spurs, joint inflammation, and pain – a finding that demonstrated that the effects were likely due to the drug itself, not the accompanying weight loss.
Human benefits
For the human portion of the trial, the team split 20 obese people suffering from knee arthritis into two groups. One group was given only hyaluronic acid injections, a common treatment to lubricate the joints in people with OA. The other group was given the hyaluronic injections as well as semaglutide. At the end of 24 weeks the researchers found that only the people in the semaglutide group reported better physical function scores and about a 17% increase in cartilage thickness.
The researchers themselves point out that the human trial here is an extremely small study. There was also no control for weight loss, as there was in the mice study. In fact, those on semaglutide in the human trial saw about an 8% decrease in BMI while those not on the drug had essentially no change in weight. Still, the study shows that exploring semaglutide as a way to combat OA and potentially regrow cartilage is a worthwhile endeavor.
Monash University’s Flavia Cicuttini, who was not involved with the study, but was part of a team that conducted a systematic review of GLP-1’s effect on OA in 2025, agrees with this cautious evaluation of results and points out a possible mechanism by which these drugs are exhibiting their effects.
“This is complicated to unravel because we know that conditions such as knee osteoarthritis are complex,” Cicuttini told Refractor. “There are different drivers of disease. Obesity related knee OA is a common one. We know that obesity doesn’t just affect the joint through biomechanical factors and loading, but also metabolically driven inflammation. Drugs originally developed to target diabetes such as the GLP-1 and also metformin result in weight loss, and both classes of drugs affect the metabolism of cells and in the case of metformin, metabolically driven inflammation.”
In addition to the potential anti-inflammatory impacts of GLP-1 drugs, the researchers believe the impact they saw on cartilage regrowth has to do with a chemical chain reaction that boosted the way cartilage cells produce energy and gave them the power to initiate a repair sequence. The finding that GLP-1s might be fundamentally changing how cells produce energy adds to our understanding of, and potential use for, the drugs going forward.
“Energy regulation governs every stage of life, from growth and development to aging and disease,” conclude the researchers in their study, which has been published in the journal, Cell Metabolism. “Following Schrödinger’s concept of negative entropy, living systems extract and manage energy to maintain order and counteract entropy-driven decay. Intricate regulation of energy metabolism … is essential for sustaining health and longevity. GLP-1R agonists, by fine-tuning energy metabolism, may exert system-wide benefits beyond glucose regulation. This metabolic precision could explain their promising effects in diverse diseases, including OA.”
