Relative efficacy of GLP ‐1 and GLP ‐1/ GIP receptor agonists in the prevention of alcohol‐use disorders using a target trial emulation approach
Authors' conclusion
In patients with T2D, tirzepatide and semaglutide treatment is associated with a lower incidence of AUD; robust randomised, controlled evidence for the use of these drugs for this novel indication is appropriate.
Study context
- Population
- Patients with T2D and no prior alcohol use disorder (AUD) diagnosis, US EHR network of over 120 million patientspropensity-matched 1:1
- Exposure
- Tirzepatide, semaglutide, liraglutide or dulaglutide vs DPP4i
- Tirzepatiden = 7,165
- Semaglutiden = 20,198
- Liraglutiden = 6,565
- Dulaglutiden = 19,061
- Outcome
- First-ever diagnosis of AUD (ICD-10 code F10)
- Follow-up
- 18-month follow-up
Methodological detailsretrospective cohort, electronic health records, propensity score matching 1:1, four emulated target trials, head-to-head analyses
- Retrospective cohort, electronic health records
- Propensity score matching 1:1
- Four emulated target trials
- Head-to-head analyses
Main finding
As reported in the abstract
Incident AUD · 18 months
Each group vs DPP4iHazard ratio (95% CI)
Tirzepatide
0.47(0.29–0.75)
Semaglutide
0.68(0.52–0.89)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate |
|---|---|
| Incident AUD, head-to-head: tirzepatide vs liraglutideSignificant risk reduction with tirzepatide | 0.47 (CI 0.24–0.92) |
Original publication
Relative efficacy of GLP ‐1 and GLP ‐1/ GIP receptor agonists in the prevention of alcohol‐use disorders using a target trial emulation approach. Diabetes Obes Metab. Published 7 October 2025. doi:10.
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