Large multi-system study using target trial emulation found consistent associations across patients with alcohol use disorder and either type 2 diabetes or obesity

BELLEVUE, Wash., July 21, 2026 (GLOBE NEWSWIRE) -- Researchers from Truveta, Johns Hopkins Bloomberg School of Public Health, Duke University, Providence, and collaborating institutions have published a new study finding that adults with alcohol use disorder (AUD) who initiated newer glucagon-like peptide-1 receptor agonists (GLP-1 RAs), including semaglutide and tirzepatide, experienced lower rates of alcohol-related hospitalization compared with patients receiving alternative treatments for diabetes or obesity.

Published in BMJ Open, the study, Association between GLP-1 receptor agonists and alcohol-related hospitalizations among adults with alcohol use disorder: A multi-target trial emulation study, analyzed electronic health record data from more than 40,000 adults with AUD and either type 2 diabetes or obesity across US health systems.

Using a target trial emulation framework designed to emulate randomized clinical trials in real-world data, researchers conducted four separate analyses representing distinct clinical populations and treatment contexts. Across these populations, initiation of semaglutide or tirzepatide was consistently associated with a lower observed risk of alcohol-related emergency department visits and hospitalizations.

Among adults with AUD and type 2 diabetes, initiation of a newer GLP-1 RA was associated with a 22%–26% lower hazard of alcohol-related hospitalization compared with other commonly prescribed diabetes medications. Among adults with AUD and obesity, newer GLP-1 RAs were associated with a 32% lower hazard of alcohol-related hospitalization compared with other anti-obesity medications. In analyses comparing GLP-1 RAs with medications approved for alcohol use disorder, researchers also observed substantially lower rates of alcohol-related hospitalization among GLP-1 RA users, though those findings should be interpreted more cautiously because the groups may have differed in ways that are difficult to fully account for by statistical approaches.

"Alcohol use disorder remains one of the most common and undertreated chronic conditions in the United States," said Hemalkumar B. Mehta, PhD, MS, Johns Hopkins Bloomberg School of Public Health Department of Epidemiology and corresponding author. "Our findings add to a growing body of evidence suggesting that GLP-1 receptor agonists may influence alcohol-related outcomes, while also highlighting the need for randomized clinical trials to determine whether these medications have a causal role in reducing alcohol-related harm."

Key findings

The study included 40,703 adults with alcohol use disorder and either type 2 diabetes or obesity.
Newer GLP-1 receptor agonists evaluated included semaglutide and tirzepatide.
Across four separate target trial emulations, initiation of newer GLP-1 RAs was associated with lower rates of alcohol-related hospitalization.
Findings were generally consistent across populations with type 2 diabetes and obesity.
Researchers observed no significant differences in non-alcohol-related hospitalization rates in the diabetes and obesity comparator analyses, supporting the specificity of the primary findings.
The authors emphasize that the observational design cannot establish causation and that randomized clinical trials are needed.

One of the most important aspects of this study is the use of target trial emulation," said Jay B. Lusk, MD, MBA, Duke University and University of North Carolina at Chapel Hill, and study co-author. "By explicitly designing the analysis to emulate the protocol of a hypothetical randomized trial and using active comparator groups, we were able to reduce several common sources of bias that often affect observational studies. While observational evidence cannot replace randomized trials, these methods help generate more credible evidence from routine clinical practice and identify important questions for future research. Most crucially, target trial emulation explicitly surfaces the methodological assumptions that underlie the analysis, allowing for a more balanced critical interpretation of the findings.”

"This work demonstrates how large-scale electronic health record data can be used to address urgent clinical questions that would otherwise take years to study," said Emma Holler, PhD, senior applied research scientist at Truveta and study co-author. "By combining comprehensive real-world data with rigorous causal inference methods, we were able to evaluate outcomes across diverse patient populations and care settings. These findings contribute important evidence to an emerging area of research and help inform future clinical investigations."

About the study

The study leveraged Truveta Data, which includes de-identified, daily refreshed EHR data from leading US health systems for more than 140 million patients. Researchers used a target trial emulation framework, active comparator design, propensity score methods, and negative control outcomes to evaluate associations between treatment initiation and alcohol-related hospitalizations over one year of follow-up.

The full study, Association between GLP-1 receptor agonists and alcohol-related hospitalizations among adults with alcohol use disorder: A multi-target trial emulation study, is available online in BMJ Open.

About Truveta

Truveta transforms healthcare into intelligence. Built with and owned by US health systems united by a mission of Saving Lives with Data, Truveta powers breakthrough discoveries, regulatory-grade evidence, and AI that improves patient care.

Truveta membership includes: Providence, Advocate Health, Trinity Health, Tenet Healthcare, Northwell Health, AdventHealth, Baptist Health of Northeast Florida, Baylor Scott & White Health, Bon Secours Mercy Health, CommonSpirit Health, Hawaii Pacific Health, HealthPartners, Henry Ford Health System, HonorHealth, Inova, Lehigh Valley Health Network, MedStar Health, Memorial Hermann Health System, MetroHealth, Novant Health, Ochsner Health, Premier Health, Saint Luke’s Health System, Sanford Health, Sentara Healthcare, Texas Health Resources, TriHealth, UnityPoint Health, Virtua Health, and WellSpan Health.

CONTACT: Ellie Lampton
Truveta
news@truveta.com

New study finds GLP-1 receptor agonists associated with lower risk of alcohol-related hospitalization among adults with alcohol use disorder