Incretin-Based Therapies and Post–Bariatric Surgery Alcohol Use Disorder
Main finding · New-onset AUDResult — go to the resultHazard ratio 0.45 95% CI 0.25–0.81Authors' conclusion
In this cohort study of patients who underwent bariatric surgery, IBT was associated with a 55% lower risk of new-onset AUD and a 41% lower risk of initiation of MAUDs compared with non-IBT AOMs. These findings suggest potential neurobehavioral benefits associated with IBTs that may inform AOM selection in this high-risk population. Prospective studies are warranted to confirm these associations and examine long-term liver-related outcomes.
Study context
- Population
- Adults who underwent bariatric surgery and subsequently received an AOM between January 1, 2020, and January 1, 2024; US electronic health record network3,990 per group after matching
- Participants
- 15,382 adults
- Exposure
- IBT vs non-IBT antiobesity medications (AOMs) after bariatric surgery
- IBTn = 11,194
- Non-IBTn = 4,188reference
- Outcome
- Incidence rates (per 1000 person-years) and hazard ratios (HRs) of new-onset alcohol use disorder (AUD) and initiation of MAUDs
- Follow-up
- Up to 2 years after AOM initiation
Methodological detailspropensity-score matched (1:1), multi-institutional US electronic health record network
- Propensity-score matched (1:1)
- Multi-institutional US electronic health record network
Main finding
New-onset AUD
Hazard ratio
0.45
95% CI 0.25–0.81
P = 0.006
By group
IBT
2.4 per 1000 person-years
Non-IBT
5.2 per 1000 person-years
As reported in the abstract
Observational data: associations, not effects.
Further findings
Per 1000 person-years
| Outcome | IBT | Non-IBT | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Initiation of MAUDsPropensity-score matched | 15.2 | 25.6 | 0.59 (0.46–0.75) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
Sensitivity analyses
- Results consistent across sensitivity analyses, incl. AOM initiation within 5 years of surgery and ≥3 AOM prescriptions
Original publication
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