The association between glucose-dependent insulinotropic polypeptide and/or glucagon-like peptide-1 receptor agonist prescriptions and substance-related outcomes in patients with opioid and alcohol use disorders: A real-world data analysis.

IF 5.2 1区医学 Q1 PSYCHIATRY Addiction Pub Date : 2024-10-16 DOI:10.1111/add.16679

Fares Qeadan, Ashlie McCunn, Benjamin Tingey

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Abstract

Aims: This study aimed to estimate the strength of association between prescriptions of glucose-dependent insulinotropic polypeptide (GIP) and/or glucagon-like peptide-1 receptor agonists (GLP-1 RA) and the incidence of opioid overdose and alcohol intoxication in patients with opioid use disorder (OUD) and alcohol use disorder (AUD), respectively. This study also aimed to compare the strength of the GIP/GLP-1 RA and substance use-outcome association among patients with comorbid type 2 diabetes and obesity.

Design: A retrospective cohort study analyzing de-identified electronic health record data from the Oracle Cerner Real-World Data.

Setting: About 136 United States of America health systems, covering over 100 million patients, spanning January 2014 to September 2022.

Participants: The study included 503 747 patients with a history of OUD and 817 309 patients with a history of AUD, aged 18 years or older.

Measurements: The exposure indicated the presence (one or more) or absence of GIP/GLP-1 RA prescriptions. The outcomes were the incidence rates of opioid overdose in the OUD cohort and alcohol intoxication in the AUD cohort. Potential confounders included comorbidities and demographic factors.

Findings: Patients with GIP/GLP-1 RA prescriptions demonstrated statistically significantly lower rates of opioid overdose [adjusted incidence rate ratio (aIRR) in OUD patients: 0.60; 95% confidence interval (CI) = 0.43-0.83] and alcohol intoxication (aIRR in AUD patients: 0.50; 95% CI = 0.40-0.63) compared to those without such prescriptions. When stratified by comorbid conditions, the rate of incident opioid overdose and alcohol intoxication remained similarly protective for those prescribed GIP/GLP-1 RA among patients with OUD and AUD.

Conclusions: Prescriptions of glucose-dependent insulinotropic polypeptide and/or glucagon-like peptide-1 receptor agonists appear to be associated with lower rates of opioid overdose and alcohol intoxication in patients with opioid use disorder and alcohol use disorder. The protective effects are consistent across various subgroups, including patients with comorbid type 2 diabetes and obesity.

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阿片类药物和酒精使用障碍患者的葡萄糖依赖性促胰岛素多肽和/或胰高血糖素样肽-1 受体激动剂处方与药物相关结果之间的关联：真实世界数据分析。

目的：本研究旨在估算葡萄糖依赖性促胰岛素多肽（GIP）和/或胰高血糖素样肽-1受体激动剂（GLP-1 RA）处方分别与阿片类药物使用障碍（OUD）和酒精使用障碍（AUD）患者的阿片类药物过量和酒精中毒发生率之间的关联强度。本研究还旨在比较合并2型糖尿病和肥胖症患者中GIP/GLP-1 RA与药物使用-结果关联的强度：设计：一项回顾性队列研究，分析来自 Oracle Cerner Real-World Data 的去标识化电子健康记录数据：约136个美国医疗系统，覆盖1亿多患者，时间跨度为2014年1月至2022年9月：研究包括 503 747 名有 OUD 病史的患者和 817 309 名有 AUD 病史的患者，年龄均在 18 岁或以上：暴露指有（一个或多个）或没有 GIP/GLP-1 RA 处方。结果是OUD队列中阿片类药物过量的发生率和AUD队列中酒精中毒的发生率。潜在的混杂因素包括合并症和人口统计学因素：研究结果：开具 GIP/GLP-1 RA 处方的患者阿片类药物过量的发生率在统计学上明显较低[OUD 患者的调整后发生率比 (aIRR) 为 0.60；95% 置信区间为 0.60；95% 置信区间为 0.60]：0.60；95% 置信区间 (CI) = 0.43-0.83]和酒精中毒（AUD 患者的 aIRR：0.50；95% CI = 0.40-0.63）。根据合并症进行分层后，OUD 和 AUD 患者的阿片类药物过量和酒精中毒事件发生率对处方 GIP/GLP-1 RA 的保护作用相似：结论：开具葡萄糖依赖性促胰岛素多肽和/或胰高血糖素样肽-1受体激动剂处方似乎与降低阿片类药物使用障碍和酒精使用障碍患者的阿片类药物过量和酒精中毒发生率有关。这种保护作用在不同亚群中是一致的，包括合并 2 型糖尿病和肥胖症的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.