A retrospective cohort study of more than 33,000 patients with type 2 diabetes showed that Novo Nordisk’s GLP-1 may lower the risk of opioid overdose by 42% to up to 68%.
Novo Nordisk’s blockbuster diabetes drug Ozempic (semaglutide) appears to lower the risk of opioid overdose in patients with type 2 diabetes, according to a study published Wednesday in JAMA Network Open.
Leveraging the federated health research network TriNetX Analytics Platform, the cohort study looked at the electronic health records of more than 33,000 patients with comorbid type 2 diabetes and opioid use disorder. Just over 3,000 patients were given semaglutide, while the remaining 30,000 were taking other anti-diabetic agents such as insulin, metformin and liraglutide.
After propensity-score matching—in which study participants were balanced according to age, sex, ethnicity and comorbidities—patients on semaglutide demonstrated a significantly lower risk of opioid overdose versus other treatment groups.
Compared with insulin, semaglutide suppressed the risk of overdoses by 58% while the GLP-1 receptor agonist held a 54% advantage over metformin. Semaglutide’s benefits were strongest against thiazolidinediones and dipeptidyl peptidase-4 inhibitors, resulting in a 68% and 63% reduction in the risk of overdoses, respectively.
Semaglutide also performed significantly better when compared against other GLP-1 therapies. Relative to liraglutide, semaglutide resulted in a statistically significant 55% reduction in overdoses.
The only other anti-diabetic medication that semaglutide was not significantly better against was Eli Lilly’s Trulicity (dulaglutide).
Despite these promising data, however, the study’s authors acknowledged that their findings have several methodological limitations, such as potentially unmeasured and uncontrolled confounders and other biases inherent in observational studies.
“Results need validation from other data resources and study populations,” the researchers said, noting that further studies are needed to “investigate the underlying mechanisms” of semaglutide’s effects on opioid use. Clinical trials are also necessary to better confirm the clinical benefits of semaglutide in this patient population.
Despite these uncertainties, Wednesday’s study adds to the growing list of potential therapeutic benefits of semaglutide and GLP-1 treatments. Last week, a paper published in JAMA Internal Medicine showed that these incretin therapies could potentially help patients with metabolic dysfunction-associated steatotic liver disease reduce their risk of progressing to cirrhosis and its related complications.
In July 2024, a separate study in the Annals of Internal Medicine showed that semaglutide may lower tobacco use disorder in diabetes patients. Meanwhile, a Phase II study suggested that GLP-1 therapies could also have cognitive benefits in neurodegenerative disorders, with Alzheimer’s disease patients on liraglutide showing slower cognitive decline versus placebo.
