ImportancePreliminary studies suggest that glucagon-like peptide-1 receptor (GLP-1) agonists, used to treat type 2 diabetes and obesity, may decrease alcohol consumption.ObjectiveTo test whether the risk of hospitalization due to alcohol use disorder (AUD) is decreased during the use of GLP-1 agonists compared with periods of nonuse for the same individual.Design, Setting, and ParticipantsThis cohort study was an observational study conducted nationwide in Sweden using data from January 2006 to December 2023. The population-based cohort was identified from registers of inpatient care, specialized outpatient care, sickness absence, and disability pension. Participants were all residents aged 16 to 64 years who had a diagnosis of AUD.ExposuresThe primary exposure was use of individual GLP-1 agonists (compared with nonuse of GLP-1 agonists), and the secondary exposure was medications with indication for AUD.Main Outcomes and MeasuresThe primary outcome was AUD hospitalization analyzed in a Cox regression within-individual model. Secondary outcomes were any substance use disorder (SUD)–related hospitalization, somatic hospitalization, and suicide attempt.ResultsThe cohort included 227 866 individuals with AUD; 144 714 (63.5%) were male and 83 154 (36.5%) were female, with a mean (SD) age of 40.0 (15.7) years. Median (IQR) follow-up time was 8.8 (4.0-13.3) years. A total of 133 210 individuals (58.5%) experienced AUD hospitalization. Semaglutide (4321 users) was associated with the lowest risk (AUD: adjusted hazard ratio [aHR], 0.64; 95% CI, 0.50-0.83; any SUD: aHR, 0.68; 95% CI, 0.54-0.85) and use of liraglutide (2509 users) with the second lowest risk (AUD: aHR, 0.72; 95% CI, 0.57-0.92; any SUD: aHR, 0.78; 95% CI, 0.64-0.97) of both AUD and SUD hospitalization. Use of any AUD medication was associated with a modestly decreased risk (aHR, 0.98; 95% CI, 0.96-1.00). Semaglutide (aHR, 0.78; 95% CI, 0.68-0.90) and liraglutide (aHR, 0.79; 95% CI, 0.69-0.91) use were also associated with decreased risk of somatic hospitalizations but not associated with suicide attempts (semaglutide: aHR, 0.55; 95% CI, 0.23-1.30; liraglutide: aHR, 1.08; 95% CI, 0.55-2.15).Conclusions and RelevanceAmong patients with AUD and comorbid obesity/type 2 diabetes, the use of semaglutide and liraglutide were associated with a substantially decreased risk of hospitalization due to AUD. This risk was lower than that of officially approved AUD medications. Semaglutide and liraglutide may be effective in the treatment of AUD, and clinical trials are urgently needed to confirm these findings.

中文翻译：

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重新利用 Semaglutide 和 Liraglutide 治疗酒精使用障碍


重要性初步研究表明，用于治疗 2 型糖尿病和肥胖症的胰高血糖素样肽-1 受体 （GLP-1） 激动剂可能会减少饮酒。目的测试与同一个体不使用 GLP-1 激动剂相比，使用 GLP-1 激动剂期间因酒精使用障碍 （AUD） 住院的风险是否降低。设计、设置和参与者该队列研究是使用 2006 年 1 月至 2023 年 12 月的数据在瑞典全国范围内进行的一项观察性研究。基于人群的队列是从住院护理、专业门诊护理、病假和残疾养老金登记册中确定的。参与者都是年龄在 16 至 64 岁之间并被诊断为 AUD 的居民。暴露主要暴露是使用单个 GLP-1 激动剂（与不使用 GLP-1 激动剂相比），次要暴露是具有 AUD 适应症的药物。主要结局和测量主要结局是在 Cox 个体内回归模型中分析的 AUD 住院。次要结局是任何物质使用障碍 （SUD） 相关的住院、躯体住院和自杀未遂。结果该队列包括 227 866 例 AUD 患者;144 714 例 （63.5%） 为男性，83 154 例 （36.5%） 为女性，平均 （SD） 年龄为 40.0 （15.7） 岁。中位 （IQR） 随访时间为 8.8 （4.0-13.3） 年。共有 133 210 人 （58.5%） 经历了 AUD 住院治疗。索马鲁肽（4321 名使用者）与 AUD 和 SUD 住院风险最低（AUD：调整后风险比 [aHR]，0.64;95% CI，0.50-0.83;任何 SUD：aHR，0.68;95% CI，0.54-0.85）和利拉鲁肽的使用（2509 名使用者）相关，AUD 和 SUD 住院风险第二低（AUD：aHR，0.72;95% CI，0.57-0.92;任何 SUD：aHR，0.78;95% CI，0.64-0.97）。 使用任何 AUD 药物与风险适度降低相关 （aHR，0.98;95% CI，0.96-1.00）。索马鲁肽 （aHR， 0.78;95% CI， 0.68-0.90） 和利拉鲁肽 （aHR， 0.79;95% CI， 0.69-0.91） 的使用也与躯体住院风险降低相关，但与自杀未遂无关 （索马鲁肽： aHR， 0.55;95% CI， 0.23-1.30;利拉鲁肽： aHR， 1.08;95% CI， 0.55-2.15）。结论和相关性在 AUD 合并肥胖/2 型糖尿病患者中，使用 semaglutide 和 liraglutide 与 AUD 住院风险显着降低相关。这种风险低于官方批准的 AUD 药物。索马鲁肽和利拉鲁肽可能对治疗 AUD 有效，迫切需要临床试验来证实这些发现。