Oral Semaglutide for Alcohol Use Disorder: A Randomized Clinical Trial

Area of Science:

• Pharmacology
• Clinical Psychology
• Addiction Medicine

Background:

• Glucagon-like peptide-1 receptor agonists, such as semaglutide, show preclinical promise in reducing alcohol consumption.
• Alcohol use disorder (AUD) is a significant public health concern requiring novel therapeutic approaches.

Purpose of the Study:

• To evaluate the efficacy of oral semaglutide in reducing alcohol craving and consumption in adults with AUD.
• To assess the impact of semaglutide on various measures of alcohol use, craving, and related consequences.

Main Methods:

• A phase 2, double-blind, randomized, parallel-arm trial involving 50 adults with moderate to severe AUD.
• Participants received either oral semaglutide (3mg then 7mg daily) or placebo for 8 weeks.
• Primary outcome: laboratory-assessed alcohol cue-elicited craving; secondary outcomes: heavy drinking days, drinks per day, and other consumption measures.

Main Results:

• Semaglutide significantly reduced heavy drinking days, naturalistic alcohol craving, and alcohol-related negative consequences compared to placebo.
• While laboratory-assessed craving and drinks per day were not significantly reduced, semaglutide improved drinks per drinking day.
• Significant reductions in cannabis use days and improvements in World Health Organization risk drinking levels were observed with semaglutide.

Conclusions:

• Oral semaglutide demonstrates potential as a treatment for alcohol use disorder, particularly in reducing heavy drinking and craving.
• Findings support previous research and warrant continued investigation and development of semaglutide for AUD treatment.
• Semaglutide may offer a novel therapeutic option for individuals seeking to manage alcohol consumption and related harms.