medwireNews: Glucagon-like peptide (GLP)-1 receptor agonists, particularly semaglutide, may be effective for the treatment of alcohol use disorder (AUD), observational study findings indicate.
Writing in JAMA Psychiatry, Markku Lähteenvuo (Ita-Suomen yliopisto Terveystieteiden tiedekunta, Kuopio, Finland) and co-authors say the drug class shows “promise as a novel treatment to reduce alcohol consumption and to prevent development of alcohol-related outcomes, but randomized clinical trials are needed to verify these initial findings.”
The authors explain that although there are effective treatments for AUDs and substance use disorders (SUDs), they may not be suitable for all patients, who are often undertreated pharmacologically.
Since previous studies have shown that GLP-1 receptor agonists may reduce alcohol consumption, Lähteenvuo and colleagues investigated their impact on AUD hospitalization and other secondary outcomes in people with AUD.
The cohort included 227,866 individuals (mean age 40 years, 63.5% men) with AUD from Swedish nationwide electronic registries. Of these, 6276 (2.8%) were using a GLP-1 receptor agonist, most commonly semaglutide (n=4321), followed by liraglutide (n=2509), dulaglutide (n=1118), and exenatide (n=98).
During a median 8.8 years of follow-up, 58.5% of the cohort were hospitalized at least once due to AUD and 60.7% were hospitalized due to any SUD.
The researchers report that semaglutide use versus non-use was associated with a significant 36% lower risk for hospitalization due to AUD after adjusting for use of psychotropic, ADHD, and diabetes medications, while the risk was a significant 28% lower with liraglutide.
In addition, the two treatments were associated with significant 32% and 22% lower adjusted risks for hospitalization due to SUD, but Lähteenvuo et al say that this finding “needs to be interpreted cautiously, as the majority of these hospitalizations were from alcohol-related causes.”
Nonetheless, “this result is in line with a recent registry study, which found that use of semaglutide was associated with reduced incidence and relapse of cannabis use disorder,” they add.
The team also points out that the risk reduction with use versus non-use of the two GLP-1 receptor agonists was greater than that seen with the use of any approved AUD medication (disulfiram, acamprosate, or naltrexone), at a nonsignificant 2% for both hospitalization outcomes. However, when the treatments were analyzed separately, the investigators found that the risks for AUD or SUD hospitalization were both a significant 14% lower with versus without naltrexone.
The risk for somatic hospitalizations during follow-up was a significant 22% lower with semaglutide use and a significant 21% lower with liraglutide use versus non-use but neither treatment was associated with a reduced risk for suicide attempts.
By comparison, use of AUD medications in general was associated with a significant 15% reduction in the risk for somatic hospitalization compared with non-use, and with a significant 15% increased risk for suicide attempts.
Neither dulaglutide nor exenatide use was significantly associated with any of the outcomes measured in this cohort.
Lähteenvuo and co-authors conclude: “As the GLP-1 receptor has been shown to be involved in many pathways related to craving and reward, it may be plausible that GLP-1 agonists could be used for a wide variety of addictions.”
They add: “A recent review suggested that GLP-1 agonists may exert a centrally mediated effect to reduce addictive behavior at least partly via dopamine modulation.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2024 Springer Healthcare Ltd, part of the Springer Nature Group
