TOPLINE

Newer GLP-1s such as semaglutide or tirzepatide were associated with a lower risk for alcohol-related emergency department (ED) visits or hospitalizations than alternative medications in adults with alcohol use disorder (AUD) and type 2 diabetes (T2D) or obesity, new research showed.

METHODOLOGY

• A retrospective cohort study included electronic health record data for nearly 41,000 adults in the US with AUD and T2D or obesity who started a newer GLP-1 (semaglutide or tirzepatide) or a relevant active comparator between 2018 and 2024.
• Researchers used a target trial emulation framework with four separate trials: the antidiabetic medication (ADM) trial, the antiobesity medication (AOM) trial, the medications for AUD with T2D (MAUD-T2D) trial, and the medications for AUD with obesity (MAUD-obesity) trial.
• Participants were followed from treatment initiation up to 1 year to identify alcohol-related ED visits or hospitalizations, defined as encounters with alcohol-related diagnoses or testing for blood alcohol, ethyl glucuronide, or ethyl sulfate levels.

TAKEAWAY

• In the ADM trial, initiation of a newer GLP-1 was associated with a lower hazard of alcohol-related hospitalization within 1 year of treatment than the use of sulfonylureas (hazard ratio [HR], 0.74) and other ADMs (DPP-4 or SGLT2 inhibitors; HR, 0.78) but not with the use of older GLP-1s.
• In the AOM trial, newer GLP-1s were associated with a lower hazard of alcohol-related hospitalization compared with other AOMs (HR, 0.68) but not with older GLP-1s.
• After propensity score matching and weighting, alcohol-related hospitalization occurred in fewer patients on a newer GLP-1 than in those on medications for AUD in the MAUD-T2D trial (13.5% vs 31.4%, respectively; HR, 0.37) and in the MAUD-obesity trial (8.0% vs 20.4%; HR, 0.35).
• Initiation of a newer GLP-1 was also linked to a significantly lower risk for non-alcohol-related hospitalization than the use of AUD medications in both the MAUD-T2D (HR, 0.70) and MAUD-obesity (HR, 0.54) trials, but there were no significant between-group differences in the ADM and AOM trials.

IN PRACTICE

The researchers noted the findings may suggest a potential role for GLP-1s in individuals with AUD. However, they added that further research, including randomized controlled trials, will be needed to evaluate effectiveness in this context.

SOURCE

The study was led by Patricia J. Rodriguez, PhD, Truveta, Inc. It was published online on July 21 in BMJ Open.

LIMITATIONS

The study was limited by potential undercapture of AUD in clinical practice due to stigmatization, residual confounding, lack of consideration of AUD severity, reliance on diagnosis codes and laboratory testing for alcohol exposure, censoring of patients at discontinuation or initiation of a comparator medication, and inclusion of post-baseline treatment information.

DISCLOSURES

The study was funded by Truveta, which employs or has employed some of the researchers. Disclosure information for all study investigators is available in the original study publication.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.