Semaglutide Use Linked to Lower Opioid Overdose Risk in Type 2 Diabetes

Compared with other antidiabetic medications, semaglutide is associated with a significantly lower risk for opioid overdose among patients with comorbid type 2 diabetes and opioid use disorder (OUD), according to study results published in JAMA Network Open.

Researchers performed a cohort study using an emulation target trial design to assess the association between antidiabetic medication use and risk for opioid overdose among patients diagnosed with type 2 diabetes and OUD. Eligible patients from the TriNetX Analytics Platform were diagnosed with both type 2 diabetes and OUD and prescribed semaglutide or other antidiabetic medications between December 2017 and June 2023. 

After propensity-score matching, the semaglutide (mean age, 57.6 years) and insulin (mean age, 57.5 years) groups each comprised 2790 participants. Before propensity-score matching, significant differences existed between the semaglutide and comparison groups regarding age, sex, ethnicity, and comorbidities.

Over a 1-year follow-up, use of semaglutide was associated with a significantly lower risk for opioid overdose than:

• Insulin (hazard ratio [HR], 0.42; 95% CI, 0.29-0.60);
• Metformin (HR, 0.46; 95% CI, 0.31-0.68);
• Dipeptidyl peptidase-4 (DPP-4) inhibitors (HR, 0.37; 95% CI, 0.23-0.61);
• Sodium-glucose cotransporter-2 (SGLT-2) inhibitors (HR, 0.58; 95% CI 0.38-0.87); and,
• Other glucagon-like peptide-1 (GLP-1) receptor agonists (HR, 0.56; 95% CI 0.36-0.87).

Study limitations include potential unmeasured or uncontrolled confounders and biases related to electronic health record-based studies.

The study authors concluded, “Semaglutide was associated with reduced opioid overdose risk in patients with comorbid [type 2 diabetes] and OUD, suggesting its potential therapeutic value for preventing overdoses.”

This article originally appeared on Endocrinology Advisor