Introduction Harmful alcohol use remains a major cause of chronic liver disease, cirrhosis, hepatocellular carcinoma (HCC), and liver-related mortality worldwide. Despite advances in hepatology care, effective pharmacologic strategies that simultaneously address alcohol use behaviour and liver disease progression are limited.
Introduction
Harmful alcohol use remains a major cause of chronic liver disease, cirrhosis, hepatocellular carcinoma (HCC), and liver-related mortality worldwide. Despite advances in hepatology care, effective pharmacologic strategies that simultaneously address alcohol use behaviour and liver disease progression are limited. Recent anecdotal observations have suggested that glucagon-like peptide-1 receptor agonists (GLP-1 RAs)—commonly used for diabetes and obesity—may reduce alcohol craving and consumption. However, their potential impact on liver-related outcomes and mortality in individuals with harmful alcohol use has not been well studied.
Summary
In this target trial emulation study using US Veterans' electronic health records, investigators evaluated the association between GLP-1 RA use and liver outcomes in patients with harmful alcohol use. A total of 8,040 GLP-1 RA initiators with positive AUDIT-C scores were propensity-score matched with 8,040 nonusers and followed longitudinally.
GLP-1 RA therapy was associated with a 30% lower risk of composite liver-related outcomes (hepatic decompensation, hepatocellular carcinoma, liver-related death, or all-cause mortality) (adjusted HR 0.70). Importantly, all-cause mortality was reduced by 57% (adjusted HR 0.43). Among semaglutide users, higher weekly doses were linked with even greater reductions in liver outcomes and mortality. Additionally, GLP-1 RA users showed lower odds of continued harmful alcohol use during follow-up (adjusted OR 0.75).
Conclusion
GLP-1 receptor agonists may offer dual benefits in patients with harmful alcohol use—reducing alcohol consumption and improving liver-related outcomes and survival. These findings suggest a potential novel therapeutic role for GLP-1 RAs in alcohol-associated liver disease, although randomized clinical trials are needed for confirmation.
Introduction: Acute kidney injury (AKI) is a frequent and life-threatening complication of cirrhosis, with management often complicated by inaccurate assessment of intravascular volume and the presence of cirrhotic cardiomyopathy (CCM). This prospective study evaluated whether...
Introduction: Acute-on-chronic liver failure (ACLF) is characterized by overwhelming systemic inflammation and immune dysregulation, leading to high short-term mortality. This study used advanced single-cell and spatial transcriptomic technologies to define the immune landscape of ACLF...
Introduction: Adults with Fontan-type circulation are increasingly recognized to develop Fontan-associated liver disease and portal hypertension. This prospective study explored the prevalence, anatomical distribution, and hemodynamic characteristics of esophageal varices (EV), with particular emphasis on...
Introduction: Acute-on-chronic liver failure (ACLF) is characterized by overwhelming systemic inflammation and immune dysregulation, leading to high short-term mortality. This study used advanced single-cell and spatial transcriptomic technologies to define the immune landscape of ACLF...
Introduction: Despite advances in the management of portal hypertension, mortality after variceal bleeding remains high in patients with cirrhosis. Experimental and clinical studies suggest that statins may improve portal hypertension and hepatic vascular function. This...
Introduction: Acute liver failure (ALF) complicated by cerebral oedema carries a high risk of early mortality, primarily due to hyperammonemia and intracranial hypertension. The optimal timing of continuous renal replacement therapy (CRRT) in these critically...
We are pioneers in clinical intelligence, dedicated to helping gastroenterologists harness the power of artificial intelligence to drive precision, efficiency, and patient growth.