ASSOCIATION BETWEEN GLP-1 RECEPTOR AGONIST USE AND INCIDENT ALCOHOL USE DISORDER AMONG PATIENTS WITH DIABETES: A REAL-WORLD EVIDENCE STUDY
Author(s)
Aubree Seibert-Jeffrey, BA, BS1, Bradley Martin, RPh, PharmD, PhD2;
1UAMS, Student, Maumelle, AR, USA, 2University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
1UAMS, Student, Maumelle, AR, USA, 2University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
OBJECTIVES: Preclinical studies suggest Glucagon Like Peptide-1 Receptor Agonists (GLP-1RAs) may reduce alcohol consumption; however, evidence in humans is limited. This study evaluated whether initiation of GLP-1RAs, compared to sodium-glucose cotransporter-2 inhibitors (SGLT2Is), was associated with reduced risk of developing alcohol use disorder (AUD) among patients with diabetes.
METHODS: In this retrospective cohort study, new users of GLP-1RAs with a diabetes diagnosis and no history of alcohol use disorder (AUD) at baseline were compared to new users of SGLT2Is identified in the U.S. TriNetX linked EHR-Claims database from 2010 to 2024. Study subjects were propensity score matched (1:1) on 22 relevant baseline characteristics assessed over a 12 month baseline window using greedy nearest neighbor matching. AUD was identified from ICD-10-CM codes and subjects were followed until incident AUD diagnosis, a 30-day gap in coverage was reached, or study end date. Kaplan-Meier log rank test and Cox Proportional Hazards (CPH) models were estimated.
RESULTS: Prior to propensity score matching there were 104,376 new users of GLP-1RAs and 85,645 new users of SGLT2Is identified, and after 73,924 in each group were retained. 20 covariates had standardized differences <0.075 after matching. Covariates with residual imbalances were included as in the CPH models. Median follow-up time was 587 days in the GLP-1RA cohort and 627 in the SGLT2I cohort. Cumulative incidence of AUD was 1.62% among GLP-1RA users compared to 2.01% of SGLT2I users. Survival was significantly higher in GLP-1RA users compared to SGLT2I users (Log-Rank χ2= 21.78, p < .0001) and GLP-1RAs were associated with a significant reduction in AUD after further adjustment (aHR=0.826; 95% CI: 0.765-0.891).
CONCLUSIONS: Initiation of GLP-1RAs was associated with lower risk of incident AUD compared to initiation of SGLT2Is among diabetics. These findings support emerging evidence that GLP-1RAs may have beneficial effects on the development of AUD.
METHODS: In this retrospective cohort study, new users of GLP-1RAs with a diabetes diagnosis and no history of alcohol use disorder (AUD) at baseline were compared to new users of SGLT2Is identified in the U.S. TriNetX linked EHR-Claims database from 2010 to 2024. Study subjects were propensity score matched (1:1) on 22 relevant baseline characteristics assessed over a 12 month baseline window using greedy nearest neighbor matching. AUD was identified from ICD-10-CM codes and subjects were followed until incident AUD diagnosis, a 30-day gap in coverage was reached, or study end date. Kaplan-Meier log rank test and Cox Proportional Hazards (CPH) models were estimated.
RESULTS: Prior to propensity score matching there were 104,376 new users of GLP-1RAs and 85,645 new users of SGLT2Is identified, and after 73,924 in each group were retained. 20 covariates had standardized differences <0.075 after matching. Covariates with residual imbalances were included as in the CPH models. Median follow-up time was 587 days in the GLP-1RA cohort and 627 in the SGLT2I cohort. Cumulative incidence of AUD was 1.62% among GLP-1RA users compared to 2.01% of SGLT2I users. Survival was significantly higher in GLP-1RA users compared to SGLT2I users (Log-Rank χ2= 21.78, p < .0001) and GLP-1RAs were associated with a significant reduction in AUD after further adjustment (aHR=0.826; 95% CI: 0.765-0.891).
CONCLUSIONS: Initiation of GLP-1RAs was associated with lower risk of incident AUD compared to initiation of SGLT2Is among diabetics. These findings support emerging evidence that GLP-1RAs may have beneficial effects on the development of AUD.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
RWD115
Topic
Real World Data & Information Systems
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)