Small trial tests semaglutide alongside therapy for alcohol use disorder

What happened

A randomized trial in Denmark tested semaglutide as an addition to cognitive behavioral therapy for people seeking treatment for alcohol use disorder. All 108 participants had moderate-to-severe alcohol use disorder and obesity. Half received weekly semaglutide, titrated toward 2.4 mg, and half received placebo for 26 weeks.

The study was double-blind and conducted at one center. Fifty-four people entered each group, and 88 participants completed the full intervention. The primary outcome was the change in the percentage of heavy-drinking days during a 30-day period at the end of treatment. Investigators analyzed all randomized participants and used multiple imputation for missing outcome data.

Heavy-drinking days decreased by 41.1 percentage points from baseline in the semaglutide group and by 26.4 points in the placebo group. The estimated difference between groups was 13.7 percentage points in favor of semaglutide, with a 95% confidence interval from 5.4 to 22.0 points. The journal abstract also reports benefits on several secondary alcohol-related and physical outcomes, but it does not give all of those estimates.

Digestive side effects were more frequent with semaglutide. The abstract describes them as temporary and generally mild or moderate. The study received support from several Danish foundations, including the Novo Nordisk Foundation.

What it means

The trial provides an early randomized signal that a GLP-1 medicine may merit further study as an add-on to structured care for alcohol use disorder in people who also have obesity. Because therapy was provided in both groups, the result concerns semaglutide added to cognitive behavioral treatment. It does not test semaglutide as stand-alone addiction care.

This is research adjacent to obesity care because the participants had obesity and the study drug is also used for weight management. The question studied, however, was alcohol consumption. The result should be read as a small addiction-treatment trial, not as evidence for a new obesity indication.

What it does not mean

The FDA has not authorized semaglutide as a treatment for alcohol use disorder. The trial did not compare it with naltrexone, acamprosate, disulfiram, or another medicine used in alcohol-use-disorder care. It therefore cannot show that semaglutide is a better choice than an approved treatment.

The study ran for six months at one Danish center and included only 108 people. It cannot establish long-term effectiveness, uncommon harms, or how well the result transfers to people without obesity, people who are not seeking treatment, or patients receiving a different behavioral program.

Stopping heavy alcohol use abruptly can cause dangerous withdrawal. This report is not a reason to change a semaglutide prescription or attempt withdrawal without medical support.