Association between glucagon-like peptide-1 receptor agonists use and change in alcohol consumption: a systematic review

Mohsan Subhani^{1

2}, Ashwin Dhanda³, James A King^{4

5}, Fiona C Warren⁶, Siobhan Creanor⁶, Melanie J Davies^{5

7}, Sally Eldeghaidy^{8

9}, Stephen Bawden⁸, Penny A Gowland⁸, Ramon Bataller^{10

11}, Justin Greenwood², Stephen Kaar¹², Neeraj Bhala^{1

2}, Guruprasad P Aithal^{1

2}

Affiliations

¹ Nottingham Digestive Diseases Centre (NDDC), Translational Medical Sciences, School of Medicine, University of Nottingham, NG7 2UH, UK.
² NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham NG7 2UH, UK.
³ Faculty of Health, University of Plymouth, Plymouth PL4 8AA, UK.
⁴ National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK.
⁵ NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, UK.
⁶ Faculty of Health and Life Sciences, University of Exeter, Exeter EX4 4QJ, UK.
⁷ Diabetes Research Centre, University of Leicester and the National Institute for Health Research Leicester Biomedical Research Centre, Leicester General Hospital, Leicester LE5 4PW, UK.
⁸ Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2UH, UK.
⁹ Division of Food, Nutrition & Dietetics, School of Biosciences, University of Nottingham, Loughborough LE12 5RD, UK.
¹⁰ Liver Unit, Hospital Clinic, Barcelona, Spain.
¹¹ Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
¹² Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, M139WL, UK.

PMID: 39764544
PMCID: PMC11701477
DOI: 10.1016/j.eclinm.2024.102920

Association between glucagon-like peptide-1 receptor agonists use and change in alcohol consumption: a systematic review

Mohsan Subhani et al. EClinicalMedicine. 2024.

. 2024 Nov 14:78:102920.

doi: 10.1016/j.eclinm.2024.102920. eCollection 2024 Dec.

Authors

Affiliations

¹ Nottingham Digestive Diseases Centre (NDDC), Translational Medical Sciences, School of Medicine, University of Nottingham, NG7 2UH, UK.
² NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham NG7 2UH, UK.
³ Faculty of Health, University of Plymouth, Plymouth PL4 8AA, UK.
⁴ National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK.
⁵ NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, UK.
⁶ Faculty of Health and Life Sciences, University of Exeter, Exeter EX4 4QJ, UK.
⁷ Diabetes Research Centre, University of Leicester and the National Institute for Health Research Leicester Biomedical Research Centre, Leicester General Hospital, Leicester LE5 4PW, UK.
⁸ Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2UH, UK.
⁹ Division of Food, Nutrition & Dietetics, School of Biosciences, University of Nottingham, Loughborough LE12 5RD, UK.
¹⁰ Liver Unit, Hospital Clinic, Barcelona, Spain.
¹¹ Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
¹² Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, M139WL, UK.

PMID: 39764544
PMCID: PMC11701477
DOI: 10.1016/j.eclinm.2024.102920

Abstract

Background: Despite the availability of various pharmacological and behavioural interventions, alcohol-related mortality is rising. This systematic review aimed to critically evaluate the existing literature on the association between glucagon-like peptide-1 receptor agonists use (GLP-1 RAs) and alcohol consumption.

Methods: Electronic searches were conducted on Ovid Medline, EMBASE, PsycINFO, clintrials.gov, and ProQuest until the end of March 2024. An updated search was done on 7th of August 2024. The primary outcome was to explore the association between GLP-1 RAs use and change in alcohol consumption. Secondary outcomes included evaluating the impact of GLP-1 RAs on occurrences of alcohol-related events, healthcare utilisation, and the effect on functional magnetic resonance imaging (fMRI) cue reactivity. This study is registered with PROSPERO #CRD42024531982.

Findings: Six studies totalling 88,190 participants were included with 38,740 (43.9%) receiving GLP-1 RA, but only 286 participated in randomised controlled trials. Pooled mean age was 49.6 years (SD = 10.5). RCT data did not show a reduction in alcohol consumption over 30 days after 24 weeks of treatment with exenatide versus placebo (heavy drinking days 6.0 [higher in control group], 95% CI -7.4 to 19.4, p = 0.37), a subgroup analysis found a positive effect in people with obesity (BMI >30 kg/m²), with significant reductions in brain reward centre cue reactivity on fMRI. In a secondary analysis of an RCT participants taking dulaglutide compared to placebo were 29% more likely to reduce alcohol intake (relative effect size 0.71, 95% CI 0.52-0.97, p = 0.04). Observational studies showed fewer alcohol-related healthcare events and a significant reduction in alcohol use with GLP-1 RAs treatment compared to DPP4-Dipeptidyl peptidase 4 use, no treatment and/or alcohol intake at baseline.

Interpretation: There is little high-quality evidence demonstrating the effect of GLP-1 RAs on alcohol use. Subgroup analysis from two RCTs and supporting data from four observational studies suggest that GLP-1 RAs may reduce alcohol consumption and improve outcomes in some individuals. Heterogeneous study findings warrant further research to establish the effectiveness and safety of GLP-1 RAs in this population.

Funding: National Institute for Health and Care Research (NIHR): Award-ID: NIHR155469; NIHR154191; NIHR155530. NIHR Nottingham Biomedical Research Centre, Award-ID: BRC-1215-20003.

Keywords: Alcohol use; Alcoholism; GLP-1 agonist; Glucagon-like peptide-1 receptor agonists; Systematic review.

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Conflict of interest statement

All authors have submitted the ICMJE COI form. Authors (MS, JK, FCW, SC, SE, SB, JG, NB) declare no conflict of interest. Authors (AD, MJD, PAG, RB, SK, GPA) have declared the following conflicts of interest. AD: Received grants or contracts from ARMS-Hub study (NIHR PHR) and BOOST trial (NIHR RfPB). Participates in the NIHR BASIS trial Drug Monitoring Committee. MJD: Received grants or contracts from AstraZeneca, Novo Nordisk, Boehringer Ingelheim, Janssen, Sanofi-Aventis, and Eli Lilly. Consulting fees from Lilly, Boehringer Ingelheim, Novo Nordisk, and Sanofi. Honoraria for lectures and presentations from Boehringer Ingelheim, Lilly, Novo Nordisk, Sanofi, and AstraZeneca. Participates in Data Safety Monitoring Boards for Boehringer Ingelheim, Eli Lilly, Novo Nordisk, Sanofi, Carmot, Zealand Pharma, Pfizer, Medtronic, and AstraZeneca. PAG: Received grants or contracts from EPSRC, BBSRC, MRC, Wellcome Leap, and NIHR. Honoraria for lectures from the International Society for Magnetic Resonance in Medicine (ISMRM). Holds leadership roles as Secretary of ISMRM and Councillor for Nottinghamshire County Council and Rushcliffe Borough Council. Received equipment or services from ASG and Philips. RB: Consulting fees from GSK, Novonordisk, and Boehringer Ingelheim. Honoraria for lectures from Gilead and Abbvie. SK: Received grants from UK NIHR for the MHIN Grant Alcohol Assertive Outreach Study, MAHSC Grant for Early Detection in Liver Fibrosis Study, and EME Grant for the MORE-KARE Study. Honoraria for a presentation to the British Association of Psychopharmacology. GPA: Received grants from NIHR, EU DILI consortium, and Gilead. Consulting fees through the Nottingham University Consultants team.

Figures

**Fig. 1**
PRISMA 2020 flow diagram for study inclusion.

See this image and copyright information in PMC

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Association between glucagon-like peptide-1 receptor agonists use and change in alcohol consumption: a systematic review

Affiliations

Association between glucagon-like peptide-1 receptor agonists use and change in alcohol consumption: a systematic review

Authors

Affiliations

Abstract

Conflict of interest statement

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References

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