Real‐World Alcohol Use Disorder Outcomes in Patients With Concurrent Metabolic Dysfunction: GLP ‐1 Receptor Agonists Versus FDA ‐Approved AUD Medications

作者：Amir Gougol, Paul Y. Kwo, William Pike, Mehdi Farokhnia, Gavin Hui, Saurabh Gombar, Babak Mirminachi · 发表于：Alimentary Pharmacology & Therapeutics · 年份：2026 · DOI：10.1111/apt.70596 · 被引用次数：4 · 研究领域：Alcohol Consumption and Health Effects、Liver Disease Diagnosis and Treatment、Diabetes, Cardiovascular Risks, and Lipoproteins

BACKGROUND: Metabolic dysfunction (MetD) and alcohol use disorder (AUD) frequently coexist as synergistic risk factors for steatotic liver disease. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are established therapies for MetD, including type 2 diabetes mellitus (T2DM) and obesity. Recent studies suggested potential beneficial effects of GLP-1RA to decrease addictive behaviours in AUD. We evaluated the outcomes of GLP-1RA therapy compared with FDA-approved pharmacotherapies for AUD, including naltrexone, acamprosate, and disulfiram, in patients with dual risk factors of MetD and AUD. METHODS: We conducted a retrospective cohort study of patients at Stanford Health Care (2017-2025). Eligible patients had a concurrent diagnosis of alcohol-related complications meeting criteria for AUD and MetD, including obesity (BMI > 25) and/or a history of T2DM with HbA1c > 5.7. Those with advanced liver disease within 1 year of diagnosis were excluded. Exposure groups included ≥ 6 months of GLP-1RA therapy (semaglutide or tirzepatide) in comparison with FDA-approved pharmacotherapies for AUD. Propensity score matching was employed to reduce the effects of confounding factors. RESULTS: In total, 1946 patients were diagnosed concurrently with AUD and MetD. Of them, 274 patients were exposed to GLP-1RA, 1272 to naltrexone, 232 to acamprosate, and 168 to disulfiram. Patients were followed for an average of 1341 days. Patients exposed to GLP-1RA had higher BMI (35.5 vs. 30.1) and more T...