Association of Glucagon-Like Peptide-1 Receptor Agonist with Progression to Liver Cirrhosis and Alcohol-Related Admissions in Patients with Alcohol Use Disorder and Diabetes: A Retrospective Cohort Study

Apr 13, 2025Drugs

Glucagon-like peptide-1 receptor agonist linked to liver disease progression and alcohol-related hospital visits in people with alcohol use disorder and diabetes

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Abstract

Use of GLP-1 receptor agonists resulted in progression to cirrhosis in 6.6% of users compared to 6.0% of dipeptidyl peptidase-4 inhibitor users.

In a matched cohort of 7302 patients, the odds of developing cirrhosis after using GLP-1RA were similar to those using DPP4i.
Alcohol-related hospital admissions occurred in 1.4% of GLP-1RA users versus 1.7% of DPP4i users.
The odds ratio for alcohol-related hospital admission indicated no significant difference between the two groups.
Findings suggest that GLP-1RA may not provide a beneficial effect on liver disease progression or hospital admissions related to alcohol use.

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AIM: 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.

METHODS: 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.

RESULTS: 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).

CONCLUSIONS: Use of GLP-1RA in patients with AUD was not associated with beneficial effect on progression to cirrhosis or alcohol-related hospital admission.

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Association of Glucagon-Like Peptide-1 Receptor Agonist with Progression to Liver Cirrhosis and Alcohol-Related Admissions in Patients with Alcohol Use Disorder and Diabetes: A Retrospective Cohort Study

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