“Repurposing Semaglutide and Liraglutide for Alcohol Use Disorder”, 2024-11-13 (; similar):
Question: Are glucagon-like peptide-1 receptor (GLP-1) agonists effective in the treatment of alcohol use disorder?
Findings: This cohort study with a median follow-up time of more than 8 years indicates that individuals are at markedly lower risk of alcohol-related hospitalizations and hospitalizations due to somatic reasons when using GLP-1 agonists, especially semaglutide, as compared with times they are not using them.
Meaning: GLP-1 agonists, especially semaglutide, offer promise as a novel treatment to reduce alcohol consumption and to prevent development of alcohol-related outcomes, but randomized clinical trials are needed to verify these initial findings.
Importance: Preliminary studies suggest that glucagon-like peptide-1 receptor (GLP-1) agonists, used to treat type 2 diabetes and obesity, may decrease alcohol consumption.
Objective: To test whether the risk of hospitalization due to alcohol use disorder (AUD) is decreased during the use of GLP-1 agonists compared with periods of nonuse for the same individual.
Design, Setting, & Participants: This cohort study was an observational study conducted nationwide [population registry] in Sweden using data from 2006-01-01–18y2023-12-31. The population-based cohort was identified from registers of inpatient care, specialized outpatient care, sickness absence, and disability pension. Participants were all residents aged 16–64 years who had a diagnosis of AUD.
Exposures: The primary exposure was use of individual GLP-1 agonists (compared with nonuse of GLP-1 agonists), and the secondary exposure was medications with indication for AUD.
Main Outcomes & Measures: The primary outcome was AUD hospitalization analyzed in a Cox regression within-individual model. Secondary outcomes were any substance use disorder (SUD)–related hospitalization, somatic hospitalization, and suicide attempt.
Results: The cohort included 227,866 individuals with AUD; 144,714 (63.5%) were male and 83,154 (36.5%) were female, with a mean (SD) age of 40.0 (15.7) years. Median (IQR) follow-up time was 8.8 (4.0–13.3) years. A total of 133,210 individuals (58.5%) experienced AUD hospitalization.
Semaglutide (4,321 users) was associated with the lowest risk (AUD: adjusted hazard ratio [aHR], 0.64; 95% CI, 0.50–0.83; any SUD: aHR, 0.68; 95% CI, 0.54–0.85) and use of liraglutide (2509 users) with the second lowest risk (AUD: aHR, 0.72; 95% CI, 0.57–0.92; any SUD: aHR, 0.78; 95% CI, 0.64–0.97) of both AUD and SUD hospitalization.
Use of any AUD medication was associated with a modestly decreased risk (aHR, 0.98; 95% CI, 0.96–1.00).
Semaglutide (aHR, 0.78; 95% CI, 0.68–0.90) and liraglutide (aHR, 0.79; 95% CI, 0.69–0.91) use were also associated with decreased risk of somatic hospitalizations but not associated with suicide attempts (semaglutide: aHR, 0.55; 95% CI, 0.23–1.30; liraglutide: aHR, 1.08; 95% CI, 0.55–2.15). [Looks underpowered with such wide CIs…]
Conclusion & Relevance: Among patients with AUD and comorbid obesity/type 2 diabetes, the use of semaglutide and liraglutide were associated with a substantially decreased risk of hospitalization due to AUD. This risk was lower than that of officially approved AUD medications. Semaglutide and liraglutide may be effective in the treatment of AUD, and clinical trials are urgently needed to confirm these findings.