Semaglutide could also help people cut down on their alcohol intake, according to the findings from the ‘Human Laboratory Screening of Semaglutide for Alcohol Use Disorder’ randomised clinical trial. The outcomes show that the semaglutide, compared with a placebo, reduced alcohol craving, drinking quantity and the frequency of heavy drinking days. The study affirms a common observation by many patients and doctors who have reported that they suddenly lose their desire for alcohol.
This is the first randomised, placebo-controlled clinical trial to study this observation, said Dr Christian Hendershot, first author of the study and Director of Clinical Research at University of Southern California’s (USC) Institute for Addiction Research.
"Two drugs currently approved to reduce alcohol consumption aren't widely used. The popularity of Ozempic and other GLP-1 receptor agonists increases the chances of broad adoption of these treatments for alcohol use disorder," said Hendershot, who is a Professor of Population and Public Health Sciences at Keck School of Medicine of USC. "Reduced alcohol intake is associated with improved health outcomes. These results justify larger studies of GLP-1 receptor agonists for alcohol use disorder."
For the trial, researchers recruited 48 adults with alcohol use disorder who were not actively seeking treatment. Alcohol use disorder is defined by a range of possible symptoms, including the inability to stop or control one's drinking despite negative consequences.
Participants had a past-month drinking history of more than seven (for women) or more than 14 (for men) standard drinks in a week as well as two or more heavy drinking episodes (four or more drinks for women and five or more for men).
One week prior to the first injection, researchers invited participants to drink their preferred alcoholic beverages over a two-hour period in a comfortable, lab setting, with instructions to delay drinking if they wished. Researchers documented delays and drinks consumed.
Participants were then randomly assigned to receive weekly, low-dose injections of semaglutide or a placebo for nine weeks, during which time their weekly drinking patterns were also measured. Afterwards, participants and researchers returned to the drinking lab to repeat the process and see what changed.
Although semaglutide treatment did not affect average drinks per calendar day or number of drinking days, but significantly reduced drinks per drinking day (p=0.04) and weekly alcohol craving (p=0.01), also predicting greater reductions in heavy drinking over time relative to placebo (p=0.04). A significant treatment-by-time interaction indicated that semaglutide treatment predicted greater relative reductions in cigarettes per day in a subsample of individuals with current cigarette use (p=0.005).
The results, measured by grams of alcohol consumed and breath alcohol concentration, indicated that semaglutide injections reduced weekly alcohol craving, reduced average drinks on drinking days, and led to greater reductions in heavy drinking days, relative to the placebo.
A key finding was that the magnitude of semaglutide's effects on several drinking outcomes was relatively greater than is often seen with existing medications to reduce alcohol cravings, even though semaglutide was only administered at the lowest clinical doses.
In the last month of treatment, those in the semaglutide group significantly reduced their number of heavy drinking days. Also, nearly 40% of people in the semaglutide group reported no heavy drinking days in the last month of treatment, compared to 20% in the placebo group.
Among a small subgroup of participants who smoked cigarettes at baseline, those treated with semaglutide had significantly greater reductions in average cigarettes per day compared to those in the placebo group.
"These data suggest the potential of semaglutide and similar drugs to fill an unmet need for the treatment of alcohol use disorder," said senior author Klara Klein of the University of North Carolina School of Medicine. "Larger and longer studies in broader populations are needed to fully understand the safety and efficacy in people with alcohol use disorder, but these initial findings are promising."
The findings were reported in the paper, ‘Once-Weekly Semaglutide in Adults With Alcohol Use Disorder A Randomized Clinical Trial’, published in JAMA Psychiatry. To access this paper, please click here
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