GLP-1 could help reduce alcohol dependence, study finds

Use of semaglutide and liraglutide was associated with a significantly lower risk of alcohol use disorder (AUD)-related hospitalizations, suggesting that these medications may hold promise in the treatment of AUD , particularly in patients with comorbid obesity or type 2 diabetes.¹

The Swedish national cohort study is published in JAMA Psychiatry.

“In this national registry-based study, the GLP-1 agonists semaglutide and liraglutide, but not other GLP-1 agonists, were associated with a significantly reduced risk of AUD-related hospitalizations and SUD (substance use disorder) as well as somatic disorders. hospitalizations,” the study researchers wrote.

In the United States, just over 28 million people ages 12 and older experienced AUD in the past year, according to the 2023 National Survey on Drug Use and Health (NSDUH).² This includes 757,000 adolescents aged 12 to 17 with AUD.

The study used Swedish national electronic registers, including specialist inpatient and outpatient visits, as well as sickness absence and disability pension diagnoses to identify people aged 16 to 65 years with AUD between 2006 and 2021.¹

A cohort of 227,886 individuals was followed from AUD diagnosis until death, emigration, or the study end date of December 31, 2023. The primary exposure was use of GLP-1 agonists including exenatide, liraglutide, dulaglutide, and semaglutide (with lixisenatide excluded due to limited use), and secondary exposure was use of AUD medications (disulfiram, acamprosate and naltrexone, nalmefene being excluded for similar reasons).

The primary outcome was hospitalization due to AUD, with secondary outcomes including SUD-related hospitalizations, somatic hospitalizations, and suicide attempts.

A total of 133,210 people were hospitalized for AUD and 138,390 for SUD. Semaglutide use was associated with the lowest risk of AUD- and SUD-related hospitalizations (adjusted hazard ratios (aHRs), 0.64 and 0.68, respectively), while liraglutide had the second lowest risk (aHR, 0.72 for AUD and 0.78 for SUD). . In contrast, medication use for AUD in general did not significantly change the risk of hospitalization for AUD or SUD (aHR 0.98).

Regarding somatic hospitalizations, semaglutide was associated with the lowest risk (aHR, 0.78) and liraglutide with the second lowest (aHR, 0.79), while AUD medication use was linked to a slight reduction in somatic hospitalizations (aHR, 0.85). Although semaglutide use did not significantly affect the risk of suicide attempts (aHR, 0.55), AUD medication use was associated with an increased risk of suicide attempts (aHR, 1.55). 15).

However, the researchers noted that this study was an observational study and therefore could only address associations and not causation.

Overall, the researchers believe the study supports the use of certain GLP-1 medications to combat alcohol dependence.

“AUDs and SUDs are undertreated pharmacologically, despite the availability of effective treatments,” the researchers wrote. “However, new treatments are also needed because existing treatments may not be suitable for all patients. GLP-1 agonists, particularly semaglutide and liraglutide, may be effective in the treatment of AUD. Randomized clinical trials are urgently needed to confirm whether GLP-1 agonists could be used to treat AUD and SUDs.

References

1. Lähteenvuo M, Tiihonen J, Solismaa A et al. Reuse of semaglutide and liraglutide for alcohol use disorders. JAMA Psychiatry. Published online November 13, 2024. doi:10.1001/jamapsychiatry.2024.3599

2. Alcohol use disorder (AUD) in the United States: age groups and demographic characteristics. NIH. Accessed November 13, 2024.