A SYSTEMATIC review investigating the impact of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on alcohol consumption has yielded some promising results, but highlighted the need for further research.
Available pharmacological and behavioural interventions are not curbing the rise in alcohol-related mortality. GLP-1 RAs may represent a novel approach for reducing alcohol use in specific populations. This review analysed six studies involving 88,190 participants (mean age: 49.6 years), with 43.9% (38,740 individuals) receiving GLP-1 RA treatment. Among these, only 286 participants were part of randomised controlled trials (RCT).
RCT data provided mixed results. Treatment with exenatide over 24 weeks did not significantly reduce heavy drinking days (6.0 days higher in the control group, 95% CI: −7.4–19.4, P=0.37). However, subgroup analysis showed a positive effect in individuals with obesity (BMI >30 kg/m²), with reductions in brain reward centre activity observed via functional MRI cue reactivity.
In another RCT, participants taking dulaglutide were 29% more likely to reduce alcohol intake compared to placebo (relative effect size: 0.71, 95% CI: 0.52–0.97, P=0.04).
Four observational studies supported these findings, revealing fewer alcohol-related healthcare events and significant reductions in alcohol use among GLP-1 RA users compared to those taking dipeptidyl peptidase-4 inhibitors, receiving no treatment, or compared to baseline alcohol intake.
The review highlights the heterogeneity of study designs and outcomes: while observational data and subgroup analyses indicate potential benefits, robust evidence from large-scale RCTs is lacking.
The authors conclude that GLP-1 RAs, commonly prescribed for diabetes and weight management, may offer additional benefits in reducing alcohol consumption, particularly for individuals with obesity. However, further studies are required to determine the safety, effectiveness, and potential mechanisms underlying GLP-1 RA effects on alcohol-related behaviours.
Reference
Subhani M et al. Association between glucagon-like peptide-1 receptor agonists use and change in alcohol consumption: a systematic review. eClinicalMedicine. 2024; DOI:10.1016/j.eclinm.2024.102920.
