Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial
- Design
- Randomized trial · 48 participants · Intermediate outcome
- Match to healthy normal-weight adults aged 55–75
- Partial matchParticipants selected for alcohol use disorder, not weight; but young (mean 40), and the outcome is drinking behaviour.
- Could weight loss explain it?
- UnlikelyNine weeks at low doses; appetite/reward effects rather than weight loss are the proposed mechanism, though reduced intake generally could contribute.
- Study tier
- Study tier 3Small, short phase 2 trial with a laboratory primary outcome.
- Assessment
- Version 2 · curated · Sep 13, 2026
Study facts come from the paper. Population match, weight-loss explanation and study tier are our judgments, made against the reference group of healthy normal-weight adults aged 55–75.
In a 9-week trial of 48 adults with alcohol use disorder, low-dose semaglutide reduced how much they drank in a lab session, drinks per drinking day and craving. Promising but small and short; larger trials are needed.
01Findings
What the study reported
- Drugs
- Semaglutide
- Dose
- 0.25 mg escalating to 1.0 mg weekly
- Route
- subcutaneous
- Treatment duration
- 9 weeks
- Comparator
- placebo
- Primary outcome
- Laboratory alcohol self-administration
- Effect
- Grams consumed beta -0.48; drinks per drinking day beta -0.41; craving beta -0.39
- 95% confidence interval
- -0.85 to -0.11
- P value
- 0.01
- Follow-up
- 9 weeks
- Adverse events
- Not detailed in abstract.
- Limitations
- Auto-classified from abstract only; effect estimates, adverse events and limitations not extracted. Requires manual review.
Who was studied
- Mean age
- 39.9
- Sex distribution
- 71% female
- Obesity status
- not an entry criterion (mean BMI ~32, full text)
- Baseline condition
- alcohol use disorder, non-treatment-seeking
Study quality details
- Study design
- Randomized controlled trial
- Sample size
- not extracted
- Randomization
- yes
- Blinding
- double-blind
- Comparator
- placebo
- Follow up duration
- 9 weeks
- Outcome type
- intermediate
- Replication
- none yet
- Consistency with other evidence
- not assessed (auto)
- Population applicability
- PARTIAL
- Statistical precision
- n=48; wide CIs
- Risk of bias
- not assessed (auto)
- Funding conflicts
- no
- Peer review status
- yes
02Funding
Funding and conflicts
- Funding
- NIH (NCATS) and institutional
- Industry funded
- No
- Manufacturer
- None identified
- Sponsor role
- no manufacturer funding identified
- Author conflicts
- See published disclosures.
- Independent replication
- no
Funding is shown on every study and never used to score it.
03Claims
Claims this study bears on
- GLP-1 receptor agonists reduce alcohol and other substance use.Supports
Phase 2 RCT, n=48, mean age 40; medium-large effects on lab drinking; NIH funded.
04Source
The source, as retrieved
Abstract
[IMPORTANCE] Preclinical, observational, and pharmacoepidemiology evidence indicates that glucagon-like peptide 1 receptor agonists (GLP-1RAs) may reduce alcohol intake. Randomized trials are needed to determine the clinical significance of these findings. [OBJECTIVE] To evaluate the effects of once-weekly subcutaneous semaglutide on alcohol consumption and craving in adults with alcohol use disorder (AUD). [DESIGN, SETTING, AND PARTICIPANTS] This was a phase 2, double-blind, randomized, parallel-arm trial involving 9 weeks of outpatient treatment. Enrollment occurred at an academic medical center in the US from September 2022 to February 2024. Of 504 potential participants assessed, 48 non-treatment-seeking participants with AUD were randomized. [INTERVENTION] Participants received semaglutide (0.25 mg/week for 4 weeks, 0.5 mg/week for 4 weeks, and 1.0 mg for 1 week) or placebo at weekly clinic visits. [MAIN OUTCOMES AND MEASURES] The primary outcome was laboratory alcohol self-administration, measured at pretreatment and posttreatment (0.5 mg/week). Secondary and exploratory outcomes, including prospective changes in alcohol consumption and craving, were assessed at outpatient visits. [RESULTS] Forty-eight participants (34 [71%] female; mean [SD] age, 39.9 [10.6] years) were randomized. Low-dose semaglutide reduced the amount of alcohol consumed during a posttreatment laboratory self-administration task, with evidence of medium to large effect sizes for grams of alcohol consumed (β, -0.48; 95% CI, -0.85 to -0.11; P = .01) and peak breath alcohol concentration (β, -0.46; 95% CI, -0.87 to -0.06; P = .03). Semaglutide treatment did not affect average drinks per calendar day or number of drinking days, but significantly reduced drinks per drinking day (β, -0.41; 95% CI, -0.73 to -0.09; P = .04) and weekly alcohol craving (β, -0.39; 95% CI, -0.73 to -0.06; P = .01), also predicting greater reductions in heavy drinking over time relative to placebo (β, 0.84; 95% CI, 0.71 to 0.99; P = .04). A significant treatment-by-time interaction indicated that semaglutide treatment predicted greater relative reductions in cigarettes per day in a subsample of individuals with current cigarette use (β, -0.10; 95% CI, -0.16 to -0.03; P = .005). [CONCLUSIONS AND RELEVANCE] These findings provide initial prospective evidence that low-dose semaglutide can reduce craving and some drinking outcomes, justifying larger clinical trials to evaluate GLP-1RAs for alcohol use disorder. [TRIAL REGISTRATION] ClinicalTrials.gov Identifier: NCT05520775.
Where this record came from
| Source | Retrieved | Identifier |
|---|---|---|
| pubmed | Sep 13, 2026 | 39937469 first ingestion |