Obesity

Retatrutide Once Weekly in Adults with Knee Osteoarthritis Pain and Obesity

N Engl J MedPublished two phase 3 trials

Authors' conclusion

In participants with painful knee osteoarthritis and obesity, treatment with retatrutide resulted in significantly greater reductions in both the WOMAC pain score and body weight than placebo. (Funded by Eli Lilly; TRIUMPH-4 and -1 ClinicalTrials.gov numbers, NCT05931367 and NCT05929066.).

Study context

Population
Adults without diabetes who had painful knee osteoarthritis and a body-mass index of at least 27underwent randomization · TRIUMPH-4 445 · TRIUMPH-1-OA 574
Comparison
Once-weekly subcutaneous retatrutide vs placebo
Outcome
TRIUMPH-4: change in the WOMAC pain score (range, 0 to 10, higher scores indicating worse pain)
Follow-up
Week 68
Methodological detailsrandomized, placebo-controlled
  • Randomized
  • Placebo-controlled

Main finding

As reported in the abstract

RETATRUTIDE 9 MG

−3.96

mean change

RETATRUTIDE 12 MG

−3.74

mean change

PLACEBO

−2.12

mean change

Estimate (95% CI)P value
RETATRUTIDE 9 MGvs PLACEBO
difference (hybrid-treatment estimand) −1.83(−2.37 to −1.30)
RETATRUTIDE 12 MGvs PLACEBO
difference (hybrid-treatment estimand) −1.61(−2.16 to −1.07)
RETATRUTIDE 9 MGvs PLACEBO
difference (ITT estimand) −1.70(−2.19 to −1.22)
P < 0.001 for all comparisons
RETATRUTIDE 12 MGvs PLACEBO
difference (ITT estimand) −1.38(−1.91 to −0.85)
P < 0.001 for all comparisons

Further findings

Mean percent change

OutcomeRETATRUTIDE 4 MGRETATRUTIDE 9 MGRETATRUTIDE 12 MGPLACEBODifference (percentage points) (95% CI)P value
TRIUMPH-4: percent change in body weight (primary end point) · week 68RETATRUTIDE 9 MGvs PLACEBOTreatment-policy strategy— not stated in the abstract−20.0%−23.7%−4.6%−15.4 (−18.7 to −12.1)P < 0.001 for both comparisons
TRIUMPH-4: percent change in body weight (primary end point) · week 68RETATRUTIDE 12 MGvs PLACEBOTreatment-policy strategy−19.2 (−22.4 to −15.9)P < 0.001 for both comparisons

— not stated in the abstract

Mean change

OutcomeRETATRUTIDE 4 MGRETATRUTIDE 9 MGRETATRUTIDE 12 MGPLACEBOEstimateP value
TRIUMPH-1-OA: change in the WOMAC pain score (primary end point) · week 80RETATRUTIDE 4 MGvs PLACEBO−3.22−3.48−3.64−1.87difference (hybrid-treatment estimand) −1.35 (95% CI −1.92 to −0.78)
TRIUMPH-1-OA: change in the WOMAC pain score (primary end point) · week 80RETATRUTIDE 9 MGvs PLACEBOdifference (hybrid-treatment estimand) −1.61 (95% CI −2.20 to −1.02)
TRIUMPH-1-OA: change in the WOMAC pain score (primary end point) · week 80RETATRUTIDE 12 MGvs PLACEBOdifference (hybrid-treatment estimand) −1.77 (95% CI −2.34 to −1.20)
TRIUMPH-1-OA: change in the WOMAC pain score (primary end point) · week 80RETATRUTIDE 4 MGvs PLACEBOdifference (ITT estimand) −0.96 (95% CI −1.61 to −0.30)P ≤ 0.005 for all comparisons
TRIUMPH-1-OA: change in the WOMAC pain score (primary end point) · week 80RETATRUTIDE 9 MGvs PLACEBOdifference (ITT estimand) −1.41 (95% CI −2.07 to −0.75)P ≤ 0.005 for all comparisons
TRIUMPH-1-OA: change in the WOMAC pain score (primary end point) · week 80RETATRUTIDE 12 MGvs PLACEBOdifference (ITT estimand) −1.64 (95% CI −2.26 to −1.02)P ≤ 0.005 for all comparisons

Safety

In both trials, serious adverse events were more common with retatrutide than with placebo, and the most common adverse events were gastrointestinal

Original publication

Retatrutide Once Weekly in Adults with Knee Osteoarthritis Pain and Obesity. N Engl J Med. Published 8 November 2026. doi:10.1056/nejmoa2610676

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