Osteoarthritis year in review 2025: Epidemiology and therapy

AIM: To summarise key epidemiological and therapeutic research on osteoarthritis (OA) published between April 2024 and March 2025. METHODS: A narrative review was conducted using the MEDLINE database, focusing on English-language studies involving human participants published between April 1, 2024 and March 31, 2025. Eligible studies included observational longitudinal studies, systematic reviews, meta-analyses, and phase II-IV randomised controlled trials (RCTs) examining OA treatment and epidemiology. A total of 1920 studies were screened by 3 authors, resulting in 133 studies considered for potential inclusion. Ultimately, 41 studies were selected. Inclusion was based on perceived importance and relevance to identifying risk factors or advancing OA treatment. RESULTS: The global burden of OA continues to rise, with a notable increase in early-onset OA, driven in part by obesity and joint injuries. Epidemiologically, body composition-characterised by high fat mass and low lean mass-emerged as a critical factor influencing OA severity and physical function. Furthermore, the presence of other chronic conditions significantly impacts OA progression and outcomes, and influences management choice, increasing the risk of patients receiving low-value care. Therapeutic interventions for OA, including intra-articular injections (e.g., corticosteroids, hyaluronic acid, stem cells) and pharmacological therapies (e.g., metformin, methotrexate), continue to show limited efficacy. Semaglutide, which targets obesity, demonstrated substantial weight and pain reductions in individuals with knee OA and obesity, suggesting a potential disease-modifying effect through weight loss. CONCLUSION: The past year's research highlights the complexity of OA and the limited effectiveness of current interventions. While therapies targeting obesity hold promise, further research is needed to confirm their role in disease modification. Personalised treatment approaches that integrate metabolic, biomechanical, and psychosocial factors may be crucial for advancing OA care management.