A study led by researchers at the University of Nottingham has found that glucagon-like peptide-1 receptor agonists use (GLP-1 RAs) may be effective in reducing alcohol use.
"Our findings show that this type of diabetes medication shows promise in reducing alcohol consumption, potentially by targeting the brain's reward centre, especially in people with a BMI over 30," said Dr Mohsen Subhani, Clinical Assistant Professor of Gastroenterology at the NIHR Nottingham Biomedical Research Center, in the School of Medicine, at the University of Nottingham. "While further research is needed, our findings suggest this could be a potential treatment option in the future for excessive alcohol use and subsequently could lead to a reduction in alcohol-related deaths.”
Their systematic review included six studies totalling 88,190 participants. Some 38,740 (43.9%) were receiving GLP-1 RA, but only 286 participated in randomised controlled trials. The 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 vs. DPP4-Dipeptidyl peptidase 4 use, no treatment and/or alcohol intake at baseline.
“In conclusion, this review underscores the promising yet heterogeneous evidence suggesting that GLP-1 RAs may reduce alcohol consumption and improve outcomes in some individuals,” the authors concluded. “It highlights the need for further robust randomised controlled trials to determine GLP-1 RA efficacy, safety and cost-effectiveness in people with alcohol use disorders.”
This study was funded by the National Institute for Health and Care Research. The findings were reported in the paper, 'Association between glucagon-like peptide-1 receptor agonists use and change in alcohol consumption: a systematic review', published in eClinicalMedicine. To access this paper, please click here
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