Association of GLP ‐1 Receptor Agonist Use With Safety Outcomes in Individuals With Opioid Use Disorder: A Target Trial Emulation
Main finding · Ten prespecified safety outcomes (gastrointestinal, renal, respiratory, psychiatric)Result — go to the resultAdjusted hazard ratio 0.65 95% CI 0.45–0.93Authors' conclusion
In a large cohort of commercially insured individuals with OUD, GLP-1 RA initiation was not associated with increased adverse gastrointestinal, renal, respiratory or psychiatric outcomes and was associated with lower risks of pancreatitis, insomnia and anxiety.
Study context
- Population
- Adults aged ≥18 years with opioid use disorder (OUD) eligible for GLP-1 RA treatment for T2D or obesity; MarketScan Commercial Claims and Encounters database (2016–2023)1,472 to 2329 users per outcome, matched
- Exposure
- GLP-1 RA initiation vs no GLP-1 RA use
- Outcome
- Ten prespecified safety outcomes: adverse gastrointestinal, renal, respiratory and psychiatric outcomes
Methodological detailstarget trial emulation, time-conditional propensity score matching
- Target trial emulation
- Time-conditional propensity score matching
Main finding
As reported in the abstract
Ten prespecified safety outcomes:
- Gastrointestinal
- Renal
- Respiratory
- Psychiatric
Adjusted hazard ratio
0.65
95% CI 0.45–0.93
GLP-1 RA usersvs Non-users
aHR 0.65 (95% CI 0.45–0.93)
- Lower risk of insomnia with GLP-1 RA use
- 0.78; 0.68-0.89 (aHR; 95% CI)
- Lower risk of anxiety with GLP-1 RA use
- 0.76; 0.67-0.86 (aHR; 95% CI)
Observational data: associations, not effects.
Further findings
Subgroups by age, sex and T2D status
- Findings generally consistent across subgroups
Original publication
Association of GLP ‐1 Receptor Agonist Use With Safety Outcomes in Individuals With Opioid Use Disorder: A Target Trial Emulation. Diabetes Obes Metab. Published 18 May 2026. doi:10.
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