Semaglutide may reduce overdose risk in those with diabetes, opioid use disorder

Key takeaways:

• Semaglutide was linked to lower risk for opioid overdose vs. other antidiabetic medications.
• However, more research is needed to validate the findings, the authors said.

Adults with type 2 diabetes and opioid use disorder who received semaglutide had significantly lower risk for opioid overdose compared with those taking other diabetes medications, a research letter in JAMA Network Open showed.

Results from the cohort study add to the list of potential treatment applications related to the glucagon-like peptide-1 (GLP-1) receptor agonist, but therapeutic benefits for treatment of opioid use disorder require confirmation in randomized studies, according to study investigators.

According to Rong Xu, PhD, a biomedical informatics professor at Case Western Reserve University, and colleagues, drug overdose deaths have remained high in the United States, with 107,543 fatalities occurring in 2023.

However, only 25% of individuals with opioid use disorder receive medications despite their effectiveness, and around 50% discontinue the treatment within 6 months, they added.

“Not everyone receives or responds to them,” Xu said in a press release. “As a result, alternative medications to help people treat [opioid use disorder] and prevent overdosing are crucial.”

Anecdotal reports of semaglutide (Wegovy/Ozempic, Novo Nordisk) decreasing drug cravings in individuals using the medication, “along with empirical studies [that] showed its therapeutic benefits in alcohol and nicotine use disorders,” led the researchers to investigate its protective effect on drug overdoses, they explained.

In the study, Xu and colleagues analyzed the electronic health record data of 33,006 people with type 2 diabetes and opioid use disorder who were prescribed any of several antidiabetic medications between December 2017 and June 2023.

The researchers performed an emulation target trial —a statistical approach that mimicked a randomized clinical trial.

Among the study cohort, 3,034 adults (mean age, 57 years; 56.5% women) received semaglutide.

Xu and colleagues reported an association between semaglutide use and a lower risk for opioid overdose during a 1-year follow-up compared with other antidiabetic medications — which included other types of GLP-1 receptor agonists — with HRs ranging from 0.32 (95% CI, 0.12-0.89) to 0.58 (95% CI, 0.38-0.87).

The researchers acknowledged some study limitations, which included possible biases and unmeasured or uncontrolled confounders.

The results demonstrate semaglutide’s “potential therapeutic value” for preventing overdoses, but the data “need validation from other data resources and study populations,“ Xu and colleagues wrote.

“Our findings suggest that it is important to continue studying semaglutide as a possible new treatment for combating this terrible epidemic,” Xu said in the release.

References:

• Popular diabetes and weight-loss drug associated with lower opioid overdose risk. Available at: https://www.eurekalert.org/news-releases/1058807. Published Sept. 25, 2024. Accessed Sept. 25, 2024.
• Wang W, et al. JAMA Netw Open. 2024;doi:10.1001/jamanetworkopen.2024.35247.