Objective:

To evaluate the efficacy of once-weekly semaglutide in reducing heavy drinking days among patients with alcohol use disorder and obesity, focusing on the primary endpoint of heavy drinking days.

Key Findings:

• Heavy drinking days decreased by 41 percentage points with semaglutide versus 26 percentage points with placebo, indicating a significant between-group difference.
• Total alcohol consumption declined by 1,550 g with semaglutide compared to 1,026 g with placebo.
• Patients on semaglutide experienced greater reductions in alcohol cravings and improved scores on alcohol use assessments.
• Bodyweight decreased by 11.2 kg with semaglutide compared to 2.2 kg with placebo.

Interpretation:

The study suggests semaglutide may be an effective treatment for alcohol use disorder, particularly in patients with obesity, though results should be interpreted with caution due to study limitations and the need for further research.

Limitations:

• Enrollment limited to patients with obesity and a predominantly White population, which may affect generalizability.
• Single-center trial may limit generalizability to broader populations.
• Cognitive behavioral therapy and frequent clinical contact may have influenced outcomes, complicating the interpretation of results.
• Durability of treatment effects beyond the study period is unknown.

Conclusion:

Semaglutide shows promise as a novel treatment for alcohol use disorder, but further research is needed to confirm long-term efficacy and generalizability, particularly in diverse populations.