A new study indicates that semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA) commonly used to treat type 2 diabetes and obesity, may significantly reduce the risk of opioid overdose in patients with both type 2 diabetes and opioid use disorder (OUD). The research, utilizing electronic health records from the TriNetX Analytics Platform, compared semaglutide to other antidiabetic medications, including other GLP-1 RAs, insulin, and metformin.
Semaglutide's Impact on Opioid Overdose Risk
The study, published in JAMA Network Open, employed a cohort design to emulate a target trial, evaluating patients for up to a year after being prescribed semaglutide or other antidiabetic medications. Propensity-score matching was used to adjust for differences in baseline characteristics. The primary outcome was opioid overdose, with hazard ratios (HRs) calculated to assess risk reduction. The results demonstrated that semaglutide was associated with a significantly lower risk of opioid overdose compared to other GLP-1 RAs like liraglutide and dulaglutide. The hazard ratios ranged from 0.32 to 0.58, indicating a 42% to 68% lower risk of overdose in the semaglutide group during the one-year follow-up period.
Expert Commentary and Context
Rong Xu, research team leader and director of the Case Western Reserve University School of Medicine Center for AI in Drug Discovery, emphasized the importance of alternative medications for OUD, stating, "Not everyone receives or responds to them. As a result, alternative medications to help people treat opioid use disorder and prevent overdosing are crucial. Therefore, our findings suggest that it is important to continue studying semaglutide as a possible new treatment for combating this terrible epidemic."
Semaglutide's Expanding Therapeutic Potential
Semaglutide, the active ingredient in Novo Nordisk’s Wegovy and Ozempic, has shown promise in various indications beyond diabetes and weight loss, including kidney failure, obesity, and heart failure. The FDA recently approved Wegovy for reducing the risk of cardiovascular death, heart attack, and stroke in adults with cardiovascular disease who are also obese or overweight.
Study Limitations and Future Directions
The authors acknowledge that the study's observational design may introduce biases and that further research, including randomized clinical trials, is needed to validate these results and explore the underlying mechanisms of semaglutide's effects on opioid use. Despite these limitations, the findings suggest that semaglutide could have therapeutic potential in reducing opioid overdose risk in patients with comorbid type 2 diabetes and OUD.
