Short answer: Osteoarthritis is the most common type of arthritis. The 2019 ACR guideline strongly recommends exercise, weight loss for people with knee or hip OA and overweight, oral NSAIDs and steroid injections for the knee. In the STEP 9 trial, semaglutide cut knee pain scores by 41.7 points vs 27.5 on placebo. BPC-157 has only a 16-person knee survey and no controlled trial.
| Compound | Best evidence | What it shows |
|---|---|---|
| Celecoxib (Celebrex) and other NSAIDs | FDA-approved for this | Approved for the signs and symptoms of osteoarthritis. The label has a boxed warning for heart attack, stroke and stomach bleeding. |
| Triamcinolone injection (Zilretta) | FDA-approved for this | An extended-release steroid approved as a knee joint injection for osteoarthritis pain. The label says repeat injections have not been shown safe and effective. |
| Semaglutide (Wegovy) | Approved for a different use | Approved for weight and heart risk, not arthritis. In STEP 9, 407 people with obesity and knee OA lost 13.7% of body weight vs 3.2% and had less pain. |
| BPC-157 | Small or early human studies | A 2026 systematic review found only 3 human studies with 30 people in total, all of poor quality. None was a controlled trial in osteoarthritis. |
"Animal or lab studies only" means no published human trial for this goal that we could find. Results in rats or cells often do not carry over to people. Compounds that are not FDA-approved have no tested label for dose, purity or safety.
NIAMS, part of NIH, describes osteoarthritis as a degenerative joint disease where the tissues in the joint break down over time. It is the most common type of arthritis and more common in older people. Joint pain and brief stiffness after rest are typical. Hands, knees, hips, neck and lower back are the joints most often affected.
Risk factors NIAMS lists include aging, overweight or obesity, past joint injury or surgery, repetitive overuse, joints that did not form correctly, and family history. Joint pain has many other causes, so a clinician should confirm it is osteoarthritis before treatment.
The 2019 American College of Rheumatology and Arthritis Foundation guideline made strong recommendations for:
It made weaker (conditional) recommendations for options such as acupuncture, acetaminophen, duloxetine and tramadol. Celecoxib (Celebrex) is approved for osteoarthritis, and like all NSAIDs its label carries a boxed warning for heart and stomach risks. Zilretta is an approved knee steroid injection, though its label says repeat use has not been shown safe and effective.
STEP 9 tested weekly semaglutide 2.4 mg against placebo for 68 weeks in 407 adults with obesity and moderate knee osteoarthritis with at least moderate pain. Both groups got diet and exercise counseling. 81.6% were women, and the average BMI was 40.3.
| Measure | Semaglutide | Placebo |
|---|---|---|
| Change in body weight | -13.7% | -3.2% |
| Change in WOMAC knee pain score (0-100) | -41.7 points | -27.5 points |
| Change in SF-36 physical function score | +12.0 points | +6.5 points |
| Stopped treatment for side effects | 6.7% | 3.0% |
Pain also improved a lot on placebo. The trial was funded by the maker, Novo Nordisk. Semaglutide is not FDA approved for osteoarthritis; the Wegovy label covers weight and heart risk.
The most cited human report is a 2021 chart review at one Florida clinic. Staff phoned 16 of 17 people who had a BPC-157 knee injection for various kinds of knee pain, not only osteoarthritis. 11 of 12 who got BPC-157 alone said their pain was much better. No standard pain or function scores were used and there was no comparison group.
A 2026 systematic review of all human BPC-157 studies found 3 studies with 30 people in total and rated the certainty of evidence very low. Its authors said BPC-157 should not be used clinically outside regulated, high-quality trials. For the animal research and FDA status, see injury recovery.
Terms on this page: GLP-1 receptor agonist · Titration (dose escalation) · Peptide · Research use only (RUO)