Hao Dai, Rotana M Radwan, Grant D Scheiffele, Huilin Tang, Amy Sheer, Hsin-Yueh Lin, Pengyue Zhang, Darlene Adirika, Kate Luong, Jiang Bian, Jingchuan Guo
{"title":"GLP-1受体激动剂和老年2型糖尿病患者的物质使用障碍：一项目标试验模拟","authors":"Hao Dai, Rotana M Radwan, Grant D Scheiffele, Huilin Tang, Amy Sheer, Hsin-Yueh Lin, Pengyue Zhang, Darlene Adirika, Kate Luong, Jiang Bian, Jingchuan Guo","doi":"10.1002/oby.70024","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1RAs), approved for type 2 diabetes (T2D) and obesity, may modulate reward pathways and reduce substance-related behaviors. This study assessed the association between GLP-1RA use and substance use-related hospitalization in older adults with coexisting T2D and substance use disorders (SUD).</p><p><strong>Methods: </strong>A retrospective cohort study using 2016-2020 Medicare data compared GLP-1RA initiators with new users of SGLT2 inhibitors (SGLT2is) or DPP-4 inhibitors (DPP4is) among adults aged ≥ 65. The primary outcome was hospitalization for any SUD; secondary outcomes included hospitalizations for alcohol use disorder (AUD) and opioid use disorder (OUD). Propensity score 1:1 matching and Cox proportional hazards models were used under an intention-to-treat approach.</p><p><strong>Results: </strong>In the GLP-1RA versus DPP4i cohort (n = 4920), GLP-1RA users had a lower risk of SUD hospitalization (HR 0.76; 95% CI, 0.67-0.86) and OUD hospitalization (HR 0.64; 95% CI, 0.43-0.96), with a nonsignificant trend for AUD (HR 0.76; 95% CI, 0.53-1.08). No significant differences were observed compared to SGLT2is (n = 4620).</p><p><strong>Conclusions: </strong>Among older adults with T2D, GLP-1RA use was associated with reduced SUD-related hospitalization versus DPP4i use, suggesting potential repurposing for SUD management.</p>","PeriodicalId":94163,"journal":{"name":"Obesity (Silver Spring, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"GLP-1 Receptor Agonists and Substance Use Disorders in Older Adults With Type 2 Diabetes: A Target Trial Emulation.\",\"authors\":\"Hao Dai, Rotana M Radwan, Grant D Scheiffele, Huilin Tang, Amy Sheer, Hsin-Yueh Lin, Pengyue Zhang, Darlene Adirika, Kate Luong, Jiang Bian, Jingchuan Guo\",\"doi\":\"10.1002/oby.70024\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1RAs), approved for type 2 diabetes (T2D) and obesity, may modulate reward pathways and reduce substance-related behaviors. This study assessed the association between GLP-1RA use and substance use-related hospitalization in older adults with coexisting T2D and substance use disorders (SUD).</p><p><strong>Methods: </strong>A retrospective cohort study using 2016-2020 Medicare data compared GLP-1RA initiators with new users of SGLT2 inhibitors (SGLT2is) or DPP-4 inhibitors (DPP4is) among adults aged ≥ 65. The primary outcome was hospitalization for any SUD; secondary outcomes included hospitalizations for alcohol use disorder (AUD) and opioid use disorder (OUD). Propensity score 1:1 matching and Cox proportional hazards models were used under an intention-to-treat approach.</p><p><strong>Results: </strong>In the GLP-1RA versus DPP4i cohort (n = 4920), GLP-1RA users had a lower risk of SUD hospitalization (HR 0.76; 95% CI, 0.67-0.86) and OUD hospitalization (HR 0.64; 95% CI, 0.43-0.96), with a nonsignificant trend for AUD (HR 0.76; 95% CI, 0.53-1.08). No significant differences were observed compared to SGLT2is (n = 4620).</p><p><strong>Conclusions: </strong>Among older adults with T2D, GLP-1RA use was associated with reduced SUD-related hospitalization versus DPP4i use, suggesting potential repurposing for SUD management.</p>\",\"PeriodicalId\":94163,\"journal\":{\"name\":\"Obesity (Silver Spring, Md.)\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-09-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Obesity (Silver Spring, Md.)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/oby.70024\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Obesity (Silver Spring, Md.)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/oby.70024","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
GLP-1 Receptor Agonists and Substance Use Disorders in Older Adults With Type 2 Diabetes: A Target Trial Emulation.
Objective: Glucagon-like peptide-1 receptor agonists (GLP-1RAs), approved for type 2 diabetes (T2D) and obesity, may modulate reward pathways and reduce substance-related behaviors. This study assessed the association between GLP-1RA use and substance use-related hospitalization in older adults with coexisting T2D and substance use disorders (SUD).
Methods: A retrospective cohort study using 2016-2020 Medicare data compared GLP-1RA initiators with new users of SGLT2 inhibitors (SGLT2is) or DPP-4 inhibitors (DPP4is) among adults aged ≥ 65. The primary outcome was hospitalization for any SUD; secondary outcomes included hospitalizations for alcohol use disorder (AUD) and opioid use disorder (OUD). Propensity score 1:1 matching and Cox proportional hazards models were used under an intention-to-treat approach.
Results: In the GLP-1RA versus DPP4i cohort (n = 4920), GLP-1RA users had a lower risk of SUD hospitalization (HR 0.76; 95% CI, 0.67-0.86) and OUD hospitalization (HR 0.64; 95% CI, 0.43-0.96), with a nonsignificant trend for AUD (HR 0.76; 95% CI, 0.53-1.08). No significant differences were observed compared to SGLT2is (n = 4620).
Conclusions: Among older adults with T2D, GLP-1RA use was associated with reduced SUD-related hospitalization versus DPP4i use, suggesting potential repurposing for SUD management.
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