Associations of semaglutide with incidence and recurrence of alcohol use disorder in real-world population

Abstract

Alcohol use disorders are among the top causes of the global burden of disease, yet therapeutic interventions are limited. Reduced desire to drink in patients treated with semaglutide has raised interest regarding its potential therapeutic benefits for alcohol use disorders. In this retrospective cohort study of electronic health records of 83,825 patients with obesity, we show that semaglutide compared with other anti-obesity medications is associated with a 50%-56% lower risk for both the incidence and recurrence of alcohol use disorder for a 12-month follow-up period. Consistent reductions were seen for patients stratified by gender, age group, race and in patients with and without type 2 diabetes. Similar findings are replicated in the study population with 598,803 patients with type 2 diabetes. These findings provide evidence of the potential benefit of semaglutide in AUD in real-world populations and call for further randomized clinicl trials.

Fig. 1. Risk of incident AUD diagnosis in patients with obesity who had no prior history of AUD.

a Comparison between propensity-score matched semaglutide and non-GLP-1RA anti-obesity medications cohorts, stratified by gender, age group, race, and diagnosis of T2DM. b Comparison between propensity-score matched semaglutide and naltrexone/topiramate cohorts, stratified by gender, age group, race, and the diagnosis of T2DM. Patients were followed for 12 months after the index event (first prescription of semaglutide, non-GLP-1 RA anti-obesity medications, or naltrexone/topiramate during 6/2021–12/2022). Hazard rates were calculated using Cox proportional hazards analysis to estimate hazard rates of outcome at daily time intervals with censoring applied. Overall risk = number of patients with outcomes during the 12-month time window/number of patients in the cohort at the beginning of the time window. AUD Alcohol use disorders, GLP-1RA glucagon-like peptide-1 receptor agonist, T2DM type 2 diabetes. Source data are provided as a Source Data file.

Fig. 2. Risk of recurrent AUD diagnosis in patients with obesity who had a prior history of AUD.

a Comparison between propensity-score matched semaglutide and non-GLP-1RA anti-obesity medications cohorts, stratified by gender, age group, race, and the status of T2DM. b Comparison between propensity-score matched semaglutide and naltrexone/topiramate cohorts, stratified by gender, age group, race, and diagnosis of T2DM. Patients were followed for 12 months after the index event (first prescription of semaglutide, non-GLP-1 RA anti-obesity medications, or naltrexone/topiramate during 6/2021–12/2022). Hazard rates were calculated using Cox proportional hazards analysis to estimate hazard rates of outcome at daily time intervals with censoring applied. Overall risk = number of patients with outcomes during the 12-month time window/number of patients in the cohort at the beginning of the time window. AUD Alcohol use disorders, GLP-1RA glucagon-like peptide-1 receptor agonist, T2DM type 2 diabetes. Source data are provided as a Source Data file.

Fig. 3. Risk of incident and recurrent AUD diagnosis in patients with T2DM.

a Comparison of 12-month risk for incident AUD diagnosis between propensity-score matched semaglutide and non-GLP-1RA anti-diabetes medications cohorts, stratified by gender, age group, race, and the diagnosis of obesity. b Comparison of 12-month risk of recurrent AUD diagnosis between propensity-score matched semaglutide and non-GLP-1RA anti-diabetes medications cohorts, stratified by gender, age group, race, and the diagnosis of obesity. c Comparison of longer-term risks of incident and recurrent AUD diagnosis between propensity-score matched semaglutide and non-GLP-1RA anti-diabetes medications cohorts. Patients were followed for 12 months, 2-year and 3-year after the index event (first prescription of semaglutide, non-GLP-1 RA anti-diabetes medications in 12/2017–5/2021). AUD Alcohol use disorders, GLP-1RA glucagon-like peptide-1 receptor agonist, T2DM type 2 diabetes. Source data are provided as a Source Data file.