---
type: source
title: "Effects of GLP-1 Receptor Agonists on Alcohol Consumption: Systematic Review and Meta-Analysis (eClinicalMedicine / Lancet 2025)"
author: "eClinicalMedicine (Lancet)"
url: https://pmc.ncbi.nlm.nih.gov/articles/PMC12663662/
date: 2025
domain: health
secondary_domains: []
format: peer-reviewed study
status: processed
processed_by: vida
processed_date: 2026-04-24
priority: high
tags: [glp-1, alcohol-use-disorder, AUD, meta-analysis, systematic-review, semaglutide, liraglutide, AUDIT, addiction, reward-circuit]
extraction_model: "anthropic/claude-sonnet-4.5"
---

## Content

Systematic review and meta-analysis of GLP-1 RA effects on alcohol consumption. Published in eClinicalMedicine (Lancet).

**Study scope:**
- 14 studies (4 RCTs + 10 observational); n = 5,262,278
- Coverage: all databases from inception to June 1, 2025

**Key pooled findings:**

*Overall AUDIT score reduction:*
- Mean difference: −7.81 points (95% CI −9.02 to −6.60; I²=87.5%)
- Clinically meaningful: a 7+ point reduction moves many patients from hazardous to non-hazardous drinking levels

*Pooled observational studies:*
- Alcohol-related events: HR 0.64 (95% CI 0.59–0.69) — 36% lower rate

*Pooled RCTs (3 trials):*
- Overall: SMD −0.24 (95% CI −0.70, 0.23) — **non-significant** (pooled)
- BUT: individual RCTs (Hendershot semaglutide, Probst dulaglutide) EACH show significant results
- Non-significance from heterogeneity (I²=87.5%) and small-sample pooling — NOT evidence of absent effects

**Best-performing agents:** Semaglutide and liraglutide showed the strongest and most consistent reductions.

**Specific RCT findings within the meta-analysis:**
- Reduced drinking days, units per drinking day, and cravings — particularly with semaglutide
- The Hendershot 2025 RCT contributes large-effect-size evidence

## Agent Notes

**Why this matters:** This is the most comprehensive synthesis of the GLP-1 + AUD evidence. The key methodological nuance is that the POOLED RCT result is non-significant due to heterogeneity, but INDIVIDUAL RCTs show significant effects. This is the extractor's key distinction: don't claim "pooled RCTs confirm" — they don't. But don't claim "RCTs are negative" — individual RCTs with semaglutide are positive.

**What surprised me:** The AUDIT score reduction of 7.81 points is clinically meaningful in absolute terms — moving patients from hazardous toward non-hazardous drinking. This is not a marginal effect.

**What I expected but didn't find:** A dose-response analysis across the meta-analytic pool — that would strengthen the mechanistic case considerably.

**KB connections:**
- Provides the meta-analytic frame for the Hendershot RCT evidence
- The observational pooled HR (0.64) aligns with the Qeadan AUD finding (IRR 0.50), giving some cross-validation
- Together, these three sources (Hendershot RCT + Qeadan real-world + this meta-analysis) constitute a coherent evidence base for the GLP-1 → AUD claim

**Extraction hints:**
- Use as the systematic review umbrella for the GLP-1 + AUD claim
- The AUDIT −7.81 points finding is extractable as a specific quantitative outcome
- The "non-significant pooled RCT" finding should be noted in the claim body as a scope limitation
- The "semaglutide and liraglutide most effective" finding could inform which agents are relevant to the claim

**Context:** eClinicalMedicine is a high-impact, peer-reviewed open-access Lancet journal. This is the most comprehensive available synthesis of GLP-1 + AUD evidence.

## Curator Notes (structured handoff for extractor)
PRIMARY CONNECTION: GLP-1 reward circuit mechanism claim — provides systematic review context
WHY ARCHIVED: The meta-analytic frame (14 studies, n=5.2M) is needed to contextualize the Hendershot RCT. The key nuance (individual RCTs positive, pooled non-significant due to heterogeneity) must appear in any extracted claim.
EXTRACTION HINT: Don't cite this as "meta-analysis confirms GLP-1 for AUD." Instead: "the evidence base now includes 4 RCTs and 10 observational studies; individual semaglutide RCTs show significant large-range effects; pooled RCT analysis is non-significant due to small-sample heterogeneity." This is the honest characterization.
