Repurposing semaglutide and liraglutide for alcohol use disorder

Preliminary studies suggest that glucagon-like peptide-1 receptor (GLP-1) agonists, used to treat type 2 diabetes and obesity, may decrease alcohol consumption. A study tested whether the risk of hospitalization due to alcohol use disorder (AUD) is decreased during the use of GLP-1 agonists compared with periods of non-use for the same individual.
An observational study was conducted nationwide in Sweden using data from January 2006 to December 2023. The population-based cohort was identified from registers of inpatient care, specialised outpatient care, sickness absence, and disability pension. Participants were all residents aged 16 to 64 years who had a diagnosis of AUD.
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. The primary outcome was AUD. Secondary outcomes were any substance use disorder (SUD)–related hospitalisation, somatic hospitalisation, and suicide attempt.
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 follow-up time was 8.8 years. A total of 133,210 individuals (58.5%) experienced AUD hospitalisation. 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 (2,509 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 hospitalisation. 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).
Among patients with AUD and comorbid obesity/type 2 diabetes, the use of Semaglutide and Liraglutide were associated with a substantially decreased risk of hospitalisation 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, the study authors argue.
Source: Lähteenvuo M, Tiihonen J, Solismaa A, Tanskanen A, Mittendorfer-Rutz E, Taipale H. Repurposing Semaglutide and Liraglutide for Alcohol Use Disorder. JAMA Psychiatry. Published online November 13, 2024. doi.org/10.1001/jamapsychiatry.2024.3599