Association of Glucagon-Like Peptide-1 Receptor Agonists With Liver-Related Outcomes and All-Cause Mortality in Patients With Harmful Alcohol Use: A Target Trial Emulation Study.
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引用次数: 0
Abstract
Introduction: Anecdotal observations report a decrease in craving for alcohol among patients taking glucagon-like peptide-1 receptor agonists (GLP-1 RA). We aimed to assess liver-related outcomes and mortality among individuals with harmful alcohol use who received GLP-1 RAs.
Methods: We emulated a target trial using the electronic health records of US Veterans with positive alcohol use disorders-concise score (AUDIT-C), comparing new initiators of GLP-1 RA between 1/3/2017 and 9/30/2024, with controls, with follow-up until outcomes or study end. Each GLP-1 RA new user with a positive AUDIT-C screen was propensity score (PS) matched 1:1 with a patient not on a GLP-1 RA. The primary outcomes were the time to a composite outcome of decompensation, hepatocellular carcinoma, liver-related death, and all-cause mortality. The secondary outcome was the proportion of patients with positive AUDIT-C scores.
Results: We matched 8,040 patients with positive AUDIT-C initiated on GLP-1 RA with 8,040 noninitiators. GLP-1 RA use was associated with a lower risk of composite liver-related outcomes (adjusted hazard ratio [aHR], 0.70; 95% confidence interval [CI] 0.56-0.87) and death (aHR 0.43, 95% CI 0.37-0.49). Among semaglutide users, a 1 mg/wk dose increase was associated with a reduced risk of composite liver-related outcomes (aHR 0.50, 95% CI 0.29-0.88) and death (aHR 0.33, 95% CI 0.19-0.58). GLP-1 RA use was also associated with lower odds of positive AUDIT-C during follow-up (adjusted Odds ratio 0.75, 95% CI 0.68-0.82).
Discussion: In this observational target trial emulation study, GLP-1 RA use was associated with a lower risk of liver outcomes, death, and harmful alcohol use.
期刊介绍:
Published on behalf of the American College of Gastroenterology (ACG), The American Journal of Gastroenterology (AJG) stands as the foremost clinical journal in the fields of gastroenterology and hepatology. AJG offers practical and professional support to clinicians addressing the most prevalent gastroenterological disorders in patients.