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Repurposing Semaglutide and Liraglutide for Alcohol Use Disorder
Markku Lähteenvuo1, Jari Tiihonen1,2,3, Anssi Solismaa4,5
1Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland.
JAMA Psychiatry
|November 13, 2024
Summary
Glucagon-like peptide-1 (GLP-1) agonists like semaglutide and liraglutide significantly reduced alcohol use disorder (AUD) hospitalizations in a large Swedish study. These findings suggest GLP-1 agonists may offer a new treatment avenue for AUD.
Area of Science:
- Endocrinology
- Psychiatry
- Public Health
Background:
- Glucagon-like peptide-1 (GLP-1) receptor agonists are established treatments for type 2 diabetes and obesity.
- Preliminary evidence suggests GLP-1 agonists may reduce alcohol consumption.
- Alcohol use disorder (AUD) poses a significant public health burden, necessitating novel therapeutic strategies.
Purpose of the Study:
- To investigate the association between GLP-1 agonist use and the risk of hospitalization for alcohol use disorder (AUD).
- To compare the risk of AUD hospitalization among GLP-1 agonist users versus non-users within the same individuals.
- To evaluate secondary outcomes including substance use disorder (SUD) hospitalizations, somatic hospitalizations, and suicide attempts.
Main Methods:
- A nationwide, population-based cohort study in Sweden (2006-2023) identified individuals aged 16-64 with an AUD diagnosis.
- Data were sourced from Swedish national registers, including inpatient care, outpatient care, sickness absence, and disability pension.
- A within-individual Cox regression model was employed to analyze the primary exposure (GLP-1 agonist use vs. nonuse) and primary outcome (AUD hospitalization).
Main Results:
- The study included 227,866 individuals with AUD. Semaglutide use was associated with the lowest risk of AUD hospitalization (aHR, 0.64) and any SUD hospitalization (aHR, 0.68).
- Liraglutide use showed the second lowest risk for AUD hospitalization (aHR, 0.72) and any SUD hospitalization (aHR, 0.78).
- GLP-1 agonists were also linked to reduced somatic hospitalizations, but not suicide attempts. Use of approved AUD medications showed a modest risk reduction (aHR, 0.98).
Conclusions:
- In patients with AUD, particularly those with comorbid obesity or type 2 diabetes, semaglutide and liraglutide were associated with a substantial decrease in AUD-related hospitalizations.
- The observed risk reduction with semaglutide and liraglutide surpassed that of officially approved AUD medications.
- These findings highlight the potential efficacy of semaglutide and liraglutide in treating AUD, warranting urgent clinical trials for confirmation.
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