Effects of glucagon-like peptide-1 receptor agonists on alcohol consumption: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis including randomized controlled trials and observational studies
PubMed 41324012 · doi:10.1016/j.eclinm.2025.103645
What was done
A systematic review and meta-analysis was conducted according to PRISMA guidelines (PROSPERO CRD420251009075) searching databases from inception to June 1, 2025. It evaluated randomized controlled trials (RCTs) and observational studies assessing GLP-1 receptor agonists (semaglutide, liraglutide, dulaglutide, exenatide, and tripeptide) on alcohol-related outcomes in adults with hazardous drinking or alcohol use disorder (AUD). The primary outcome was change in Alcohol Use Disorders Identification Test (AUDIT) score (0–40 range). Secondary outcomes included consumption metrics, relapses, abstinence, alcohol-related diagnoses/hospitalizations, biomarkers (PEth, γ-GT), and neuroimaging measures of craving and reward.
What was found
Fourteen studies were included (4 RCTs, 10 observational; total n = 5,262,268). GLP-1 RA use was associated with a significant reduction in AUDIT scores (mean difference -7.81 points; 95% CI -9.02 to -6.60; I² = 87.5%). RCTs showed decreases in drinking days, units per drinking day, and cravings, particularly with semaglutide. Population-based and observational studies showed lower risks of incident and recurrent AUD, intoxication, and hospitalization. Biomarkers (PEth, γ-GT) showed reductions, and neuroimaging studies demonstrated attenuated cue reactivity and dopaminergic signaling.
Why it matters
This review provides evidence that GLP-1 receptor agonists can attenuate central reward responses and reduce hazardous drinking and clinical harms, supporting their potential repurposing for AUD management.
Limits
Only 4 of the 14 included studies were RCTs, meaning the vast majority of the population comes from observational studies vulnerable to residual confounding. The primary outcome analysis showed very high statistical heterogeneity (I² = 87.5%). Exact effect sizes and confidence intervals for secondary endpoints were not reported in the abstract.
Cited by
- supports Animal studies, small trials, and opportunistic epidemiological studies show a pattern of semaglutide reducing alcohol consumption.
- supports Published literature shows that GLP-1 receptor agonists reduce alcohol cravings.