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 5 · Checked against the source by AI · Oct 19, 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, but did not change average drinks per calendar day or the number of drinking days. 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; no effect on average drinks per calendar day or number of drinking days
- 95% confidence interval
- -0.85 to -0.11
- P value
- 0.01
- Follow-up
- 9 weeks
- Adverse events
- Not detailed in abstract.
- Limitations
- Not extracted
Who was studied
- Mean age
- 39.9
- Sex distribution
- 71% female
- Obesity status
- not reported in abstract; full text not checked
- Baseline condition
- alcohol use disorder, non-treatment-seeking
- Sample size
- 48
Study quality details
- Study design
- Randomized controlled trial
- Sample size
- 48
- 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
- Not reported in the abstract; full text not checked.
- 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 in 48 non-treatment-seeking adults with alcohol use disorder (mean age 39.9): low-dose semaglutide reduced laboratory alcohol consumption, drinks per drinking day and craving, but did not change average drinks per calendar day or number of drinking days. 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 |