Semaglutide in alcohol use disorder and comorbid obesity

Klausen et al investigated the use of once-weekly semaglutide versus placebo in patients with alcohol use disorder and comorbid obesity (1):

• a 26-week, single-centre, randomised, double-blinded, placebo-controlled trial, treatment-seeking participants with moderate to severe alcohol use disorder and comorbid obesity were assigned (1:1) to receive once-weekly semaglutide (2·4 mg subcutaneously) or placebo (saline subcutaneously), in addition to standard cognitive behavioural therapy
• primary endpoint was a reduction in the number of heavy drinking days assessed after 26 weeks of intervention, analysed with an ANCOVA model

Study results:

• 108 participants (53 women and 55 men) were enrolled, with 54 participants in each of the semaglutide and placebo treatment groups, and all were included in the data analysis
• overall, 88 participants (81%) completed the full intervention
• semaglutide was associated with a reduction in heavy drinking days (–41·1 percentage points from baseline, 95% CI –48·7 to –33·5) compared with placebo (–26·4, –34·1 to –18·6; estimated treatment difference –13·7 percentage points, –22·0 to –5·4; p=0·0015), and had substantial effects on multiple secondary alcohol-related and somatic outcomes
• adverse events were transient, generally mild to moderate gastrointestinal effects, and occurred more frequently in the semaglutide group

Study authors stated:

“..Semaglutide showed robust therapeutic effects in treatment-seeking participants with obesity and alcohol use disorder and this trial supports previous preclinical and clinical findings suggesting GLP-1 receptor agonists as a potential novel treatment target for alcohol use disorder…”

Reference:

1. Klausen M, Justesen S, Pedersen J et al.Once-weekly semaglutide versus placebo in patients with alcohol use disorder and comorbid obesity: a randomised, double-blind, placebo-controlled trial. Lancet 2026; 407: 1687-1698.