Al-Moussally Feras, Khan Saud, Katukuri Vinay, Kinaan Mustafa, Mansi Ishak A
Internal Medicine Residency, University of Central Florida HCA Healthcare GME, Greater Orlando, FL, USA.
Department of Internal Medicine, University of Central Florida College of Medicine, Orlando, FL, 32827, USA.
Drugs. 2025 Jun;85(6):813-825. doi: 10.1007/s40265-025-02177-x. Epub 2025 Apr 13.
In recent years, use of glucagon-like peptide-1 receptor agonists (GLP-1RA) has exponentially increased due to their beneficial effects on weight loss and cardiovascular outcomes. Lately, some animal studies and observational data suggested that GLP-1RA may be useful in the treatment of alcohol use disorder (AUD). We aim to compare the risk of progression to liver cirrhosis and alcohol-related hospital admission after initiation of GLP-1RA versus dipeptidyl peptidase-4 inhibitors (DPP4i), as the active comparator, in patients with type 2 diabetes mellitus and AUD.
We conducted a retrospective propensity score-matched cohort study, utilizing new-user and active comparator design. The study used data from the Veterans Health Administration during fiscal years 2006 to 2021 encompassing adults with AUD who initiated either GLP-1RA or DPP4i prescriptions. Our two co-primary outcomes were progression to cirrhosis (compensated and decompensated cirrhosis) and alcohol-related hospital admission.
The eligible cohort included 9965 GLP-1RA users and 19,688 DPP4i users. After propensity score matching, 7302 pairs were matched on 79 characteristics without residual imbalances. In the propensity score-matched cohort, progression to cirrhosis occurred in 6.6% of GLP-1RA users and 6.0% DPP4i users; odds ratio (OR): 1.1, 95% confidence interval (95% CI): 0.97-1.26. Alcohol-related hospital admission occurred in 1.4% of GLP-1RA users and in 1.7% of DPP4i users (OR: 0.85; 95% CI: 0.65-1.11).
Use of GLP-1RA in patients with AUD was not associated with beneficial effect on progression to cirrhosis or alcohol-related hospital admission.
近年来，胰高血糖素样肽-1受体激动剂（GLP-1RA）因其对体重减轻和心血管结局的有益作用而使用量呈指数级增长。最近，一些动物研究和观察数据表明，GLP-1RA可能对酒精使用障碍（AUD）的治疗有用。我们旨在比较2型糖尿病合并AUD患者开始使用GLP-1RA与作为活性对照的二肽基肽酶-4抑制剂（DPP4i）后进展为肝硬化和酒精相关住院的风险。
我们进行了一项回顾性倾向评分匹配队列研究，采用新用户和活性对照设计。该研究使用了2006财年至2021财年退伍军人健康管理局的数据，涵盖开始使用GLP-1RA或DPP4i处方的患有AUD的成年人。我们的两个共同主要结局是进展为肝硬化（代偿性和失代偿性肝硬化）和酒精相关住院。
符合条件的队列包括9965名GLP-1RA使用者和19688名DPP4i使用者。经过倾向评分匹配后，7302对在79个特征上进行了匹配，没有残留不平衡。在倾向评分匹配队列中，6.6%的GLP-1RA使用者和6.0%的DPP4i使用者进展为肝硬化；比值比（OR）：1.1，95%置信区间（95%CI）：0.97-1.26。1.4%的GLP-1RA使用者和1.7%的DPP4i使用者发生了酒精相关住院（OR：0.85；95%CI：0.65-1.11）。
在患有AUD的患者中使用GLP-1RA与进展为肝硬化或酒精相关住院的有益效果无关。
