GLP-1 agonists semaglutide, liraglutide may help to treat alcohol use disorder

Key takeaways:

• Participants on semaglutide had reduced risk for hospitalization due to preexisting alcohol use disorder, researchers found.
• Semaglutide and liraglutide were associated with risk for somatic hospitalization.

Patients with alcohol use disorder who used GLP-1 agonists to treat obesity or type 2 diabetes had a decreased risk for hospitalization due to alcohol use disorder, according to a study published in JAMA Psychology.

These findings support previous Healio coverage that showed that GLP-1 agonists were associated with lower rates of alcohol intoxication in patients with alcohol use disorder (AUD).

Preclinical studies in animals and human case reports have demonstrated that GLP-1 agonists can reduce alcohol consumption, Markku Lähteenvuo, MD, PhD, postdoctoral researcher with the department of forensic psychiatry at the University of Eastern Finland Niuvanniemi Hospital, and colleagues wrote.

This inspired the researchers to use data from Swedish nationwide registries to investigate how the use of individual GLP-1 agonists — including exenatide, liraglutide, dulaglutide (Trulicity, Eli Lilly & Co.) and semaglutide (Ozempic/Wegovy, Novo Nordisk) — would influence the risk for hospitalization due to AUD compared with periods of nonuse, with hospitalization due to substance use disorder (SUD), somatic reasons or suicide attempt serving as secondary outcomes.

The retrospective, population-based, observational cohort study included 227,866 participants (63.5% male; mean age, 40 years; standard deviation [SD], 15.7 years) aged 16 to 64 years who were diagnosed with AUD from 2006 to 2021, 6,276 (64.7% male; mean age, 46 years; SD, 12.5 years) of whom used GLP-1 agonists.

The main exposure of the study was use of GLP-1 agonists, but the researchers also investigated AUD medications as a second exposure.

Median follow up was 8.8 years, during which Lähteenvuo and colleagues found that 133,210 individuals (58.5%) were hospitalized for AUD at least once, and 138,390 individuals were hospitalized for any SUD.

Compared with nonuse of GLP-1 agonists, participants who used semaglutide (n = 4,321) had the lowest risk for hospitalization due to AUD (adjusted HR = 0.64; 95% CI, 0.5-0.83) or any SUD (aHR = 0.68; 95% CI, 0.54-0.85), followed by liraglutide (AUD: aHR = 0.72; 95% CI, 0.57-0.92; SUD: aHR = 0.78; 95% CI, 0.64-0.97).

Comparatively, the researchers found that use of any AUD medication did not significantly alter the risk for AUD (aHR = 0.98; 95% CI, 0.96-1) or SUD (aHR = 0.98l 95% CI, 0.97-1) hospitalization, although there was a reduced risk when looking at naltrexone individually.

Concerning secondary outcomes, semaglutide was associated with the lowest risk for somatic hospitalization (aHR = 0.78; 95% CI, 0.68-0.9) followed by liraglutide (aHR = 0.79; 95% CI, 0.69-0.91), but use of GLP-1 agonists was not associated with a risk for suicide attempts. Notably, the researchers found that participants who used AUD medications also had a reduced risk for somatic hospitalization (aHR = 0.85; 95% CI, 0.83-0.88).

Lähteenvuo and colleagues reported limitations to this trial, including its inability to determine causality as an observational study.

“Randomized clinical trials are urgently needed to confirm whether GLP-1 agonists could be used to treat AUD and SUDs,” they wrote.