Glucagon-like peptide-1 receptor agonist (GLP-1 RA) initiation was not associated with increased gastrointestinal, renal, respiratory, or psychiatric adverse outcomes in adults with opioid use disorder (OUD), according to a retrospective cohort study published in Diabetes, Obesity and Metabolism.
The analysis used the MarketScan Commercial Claims and Encounters database from 2016 through 2023 and included adults aged 18 years or older with OUD who were eligible for GLP-1 RA treatment for type 2 diabetes mellitus (T2DM) or obesity. The study followed a target trial emulation framework.
Separate analytic cohorts were constructed for each of the 10 prespecified safety outcomes using time-conditional propensity score matching, with hazard ratios comparing GLP-1 RA users and non-users.
Findings
- GLP-1 RA use was associated with a lower risk of pancreatitis (aHR, 0.65; 95% CI, 0.45-0.93).
- No increased risks of gastroparesis, acute kidney injury (AKI), or aspiration pneumonitis were observed among GLP-1 RA users.
- GLP-1 RA use was associated with lower risks of insomnia (aHR, 0.78; 95% CI, 0.68-0.89) and anxiety (aHR, 0.76; 95% CI, 0.67-0.86).
- No increased risks of depression, stress-related disorders, eating disorders, or suicidal behavior or ideation were observed.
- Findings were generally consistent across subgroups stratified by age, sex, and T2DM status.
The findings suggest that GLP-1 RA initiation in adults with OUD was not associated with increased gastrointestinal, renal, respiratory, or psychiatric adverse outcomes.
