GLP-1 RAs lower risk of liver-related outcomes, death in patients with harmful alcohol use

Using glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may reduce the risk of liver outcomes, death, and harmful alcohol use in patients with alcohol use disorder, reveals a study.

A team of investigators emulated a target trial using the electronic health records of US veterans with positive alcohol use disorders-concise score (AUDIT-C). They compared new users of GLP-1 RA between 3 January 2017 and 30 September 2024 with controls, with follow-up until outcomes or study end. Each new user with a positive AUDIT-C screen was propensity-score matched with a patient not on GLP-1 RA.

The time to a composite outcome of decompensation, hepatocellular carcinoma, liver-related death, and all-cause mortality served as the primary outcome, while the proportion of patients with positive AUDIT-C scores was secondary.

A total of 8,040 patients with positive AUDIT-C initiated on GLP-1 RA were matched with 8,040 noninitiators. The use of GLP-1 RA correlated with a lower risk of composite liver-related outcomes (adjusted hazard ratio [aHR], 0.70, 95 percent confidence interval [CI], 0.56‒0.87) and death (aHR, 0.43, 95 percent CI, 0.37‒0.49).

Among patients using semaglutide, a 1-mg/week dose increase resulted in a lower risk of composite liver-related outcomes (aHR, 0.50, 95 percent CI, 0.29‒0.88) and death (aHR, 0.33, 95 percent CI, 0.19‒0.58). Moreover, the use of GLP-1 RA correlated with a lower likelihood of positive AUDIT-C during follow-up (adjusted odds ratio, 0.75, 95 percent CI, 0.68‒0.82).