The impact of approved anti-obesity medications on osteoarthritis.

BACKGROUND: Obesity has been established as a significant risk factor for osteoarthritis. Anti-obesity medications (AOMs) have demonstrated efficacy in weight management. However, potential impact on osteoarthritis risk remains uncertain. METHODS: This retrospective cohort study used Kythera data from NOV2022 to JULY2024. Patients with obesity using AOMs were identified through diagnosis and prescription claims for tirzepatide, semaglutide, or liraglutide between 1NOV2023 and 31JAN2024, with a 6-month follow-up to assess OA risk. OA risk, analyzed using Cox regression and propensity score matching, controlled for comorbidities and sociodemographic factors. RESULTS: There were 39,394 patients living with obesity using AOM (23,933 semaglutide 12,854 tirzepatide, 2,607 liraglutide) and 72,405 without AOM use. The adjusted osteoarthritis risk was 27% % lower in AOM users than in non-users (hazard ratio (HR) = 073, 95% CI (0.67-0.79), p < 0.01). Among AOMs, tirzepatide was associated with a significantly lower osteoarthritis (OA) risk compared to semaglutide (HR = 0.57, 95% CI: 0.50-0.65, p < 0.0001). Liraglutide was linked to a significantly higher OA risk vs tirzepatide (HR = 1.63, 95% CI: 1.23-2.15, p = 0.0007). CONCLUSIONS: AOM use was associated with a significantly lower risk of OA and may be an effective obesity management intervention.

The association between weight loss medications and cardiovascular complications.

OBJECTIVE: Obesity and its cardiovascular complications are major causes of morbidity and mortality. Little is known in real-world settings about the effect of newly approved antiobesity medications (AOMs) on cardiovascular complications among patients with obesity. METHODS: This retrospective cohort study examined the association between newly approved AOM use and cardiovascular events among Medicare patients with obesity using data from 2020 to 2022. Patient age, gender, comorbidity scores, socioeconomic status, and baseline cardiovascular comorbidities were compared descriptively. Subgroup analysis compared variables by medication type. Relative risk and absolute risk of cardiovascular disease (CVD) events were estimated using Cox and Aalen regression models. RESULTS: The analysis included 5926 patients treated with semaglutide and tirzepatide, including Ozempic (5404 patients), Wegovy (375 patients), or Mounjaro (147 patients). Hypertension, type 2 diabetes, and hyperlipidemia were the most common comorbidities. For patients with AOMs, less incidence of heart failure (4.89% vs. 6.13%, p < 0.0001), atrial fibrillation (3.83% vs. 5.17%, p < 0.0001), arrhythmia (3.59% vs. 4.14%, p < 0.0153), and peripheral vascular disease (3.44% vs. 2.94%, p < 0.0395) was found versus patients without AOMs. Patients receiving AOMs showed an 8% risk reduction in any CVD. Protective effect on CVD was apparent over the first 375 days. CONCLUSIONS: Results suggest that utilization of AOMs effectively alleviates the high prevalence of CVD.

Mental health disparities in young adults with arrest history: a survey-based, cross-sectional analysis.

BACKGROUND: Over 4.53 million arrests were made in 2021 in the United States. People under 26 years of age were more likely to be arrested than older people. Although mental health disparities are prominent in the incarcerated population, the subject has not been closely examined among young adults specifically. OBJECTIVES: This study examines how criminal justice involvement, specifically arrests, affects the mental health of adults between 18 and 25 years of age. METHODS: We analyzed secondary data using the 2021 National Survey on Drug Use and Health (NSDUH). The study used a subsample of 13,494 people aged 18 to 25 years, including 7,330 women and 6,164 men. History of arrest was the key independent variable. Depression, serious mental illness (SMI), substance use, suicidal ideation, and suicide attempt were the outcome variables. We performed five multivariate logistic regression models for each outcome variable, controlling for race/ethnicity, income, and education level for men and women separately. RESULTS: Of 13,494 respondents, 6.63% had a history of arrest. Among young women, a history of arrest was associated with significantly higher adjusted odds ratios for all mental health concerns. Most notably, a history of arrest increased the likelihood of substance use by a factor of 15.19, suicide attempts by 2.27, SMI by 1.79, suicidal ideation by 1.75, and depression by 1.52. Among young men, a history of arrest was associated with increased adjusted odds ratios (AORs) for substance use (AOR, 13.37; p < .001), suicidal ideation (AOR, 1.45; p = .011), and suicide attempt (AOR, 1.82; p = .044). CONCLUSIONS: We found a strong relationship between young people having an arrest history and mental health concerns. More specifically, a history of arrest was associated with all mental health concerns among young women, while it was associated with only substance use and suicide among young men. Providing arrestees with appropriate mental health care would benefit them and the criminal justice system by decreasing the odds of recidivism.

Short-term and long-term behavioral effects of vaccination mandates.

Current COVID-19 vaccination levels are insufficient to achieve herd immunity. To implement effective interventions toward ending the pandemic, it is essential to understand why people are motivated and willing to receive vaccination. The study aims to evaluate attitudes toward COVID-19 vaccination mandates and the impact of policies on future vaccine uptake and behavior utilizing self-determination theory. We conducted an online survey (n = 569) in the U.S. and Turkey to investigate a relationship between respondents' psychological needs and their willingness and motivation to receive COVID vaccination. The study examined the possible impact of vaccine mandates on these needs. Autonomy satisfaction was the leading predictor of willingness to receive vaccination (p < .0001). Relatedness satisfaction was the leading predictor of one's intention to receive vaccination (OR = 3.382; p = .0001). The strongest positive correlation was found between needs frustration and external motivation. A moderate positive correlation was found between competence frustration and introjected motivation. No association was found between vaccine mandates and psychological needs. Need satisfaction, especially autonomy and relatedness, appear to positively influence willingness and intention to receive a vaccination. On the other hand, need frustration, especially autonomy and competence frustration, correlates with external motivation, thereby suggesting a detrimental long-term effect on vaccination behavior. Need satisfaction promotes positive vaccination behavior, while need frustration might adversely affect motivation and willingness to receive vaccination. Strategies promoting autonomous decision-making might be more effective than vaccination enforcement in sustaining positive vaccination behavior.