{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T04:24:16Z","timestamp":1768969456827,"version":"3.49.0"},"posted":{"date-parts":[[2026,1,16]]},"group-title":"Pharmacology and Therapeutics","reference-count":29,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,1,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Importance<\/jats:title>\n                  <jats:p>Alcohol use is a leading cause of morbidity and mortality worldwide. Growing evidence suggests that glucagon-like peptide-1 receptor agonists (GLP-1RAs) may represent a novel potential pharmacotherapeutic tool for alcohol use disorder (AUD).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To examine the association between GLP-1RA prescriptions and alcohol use.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>\n                    This cohort study used a cross-sectional measure of alcohol consumption and longitudinal electronic health record (EHR) data collected between 1981 and October 2023 from NIH\u2019s\n                    <jats:italic>All of Us<\/jats:italic>\n                    Research Program participants.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>\n                    <jats:italic>All of Us<\/jats:italic>\n                    is a large program to recruit and collect surveys, EHR, genomic, and wearable data from a wide array of Americans. The data presented here are from the\n                    <jats:italic>All of Us<\/jats:italic>\n                    Curated Data Repository version 8.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>\n                    393,596\n                    <jats:italic>All of Us<\/jats:italic>\n                    participants with EHR data recruited across the United States.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Exposure<\/jats:title>\n                  <jats:p>At least two GLP-1RA prescription records in the EHR.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Main Outcomes and Measures<\/jats:title>\n                  <jats:p>Alcohol Use Disorders Identification Test (AUDIT-C) scores and responses to individual AUDIT-C questions.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\n                    Among 15,447 participants with at least two recorded GLP-1RA prescriptions on separate days, 3650 had active GLP-1RA prescriptions, 5642 would have future GLP-1RA prescriptions (primary comparison group), and 544 had former GLP-1RA prescriptions. Those with active GLP-1RA prescriptions had statistically significant but modestly lower AUDIT-C scores on average compared with those with future prescriptions (incidence rate ratio [IRR] of 0.95; 95% CI, 0.91-0.99;\n                    <jats:italic>P<\/jats:italic>\n                    = 0.01). Participants with a former GLP-1RA prescription had lower AUDIT-C scores compared with those with future prescriptions, but this difference was not statistically significant. Results were similar using a propensity-score matched comparison group with a lower average AUDIT-C score for the current GLP-1RA group (IRR = 0.89; 95% CI, 0.85-0.93;\n                    <jats:italic>P<\/jats:italic>\n                    = &lt;0.001) and no significant difference for the former prescription group. Analysis of individual AUDIT-C questions shows a significant association with GLP-1RA prescriptions and frequency of drinking but not drinks per occasion or binge drinking.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions and Relevance<\/jats:title>\n                  <jats:p>This study\u2019s findings indicate that GLP-1RAs may reduce alcohol consumption by decreasing use frequency. Experimental studies and randomized controlled trials are needed to test the mechanisms and potential efficacy of GLP-1RAs in people with AUD.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>KEY POINTS<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Question<\/jats:title>\n                    <jats:p>Is there an association between glucagon-like peptide-1 receptor agonist (GLP-1RA) prescriptions and alcohol consumption?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      In this observational cohort study of 15 447 people with GLP-1RA prescriptions in NIH\u2019s\n                      <jats:italic>All of Us<\/jats:italic>\n                      cohort, active GLP-1RA prescriptions were associated with significantly lower Alcohol Use Disorders Identification Test (AUDIT-C) scores compared with scores of those who would have GLP-1RAs in the future and of a matched comparison group with no GLP-1RAs. People with former GLP-1RAs did not have lower AUDIT-C scores than these comparison groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Meaning<\/jats:title>\n                    <jats:p>Active GLP-1RA use may be effective in reducing alcohol consumption.<\/jats:p>\n                  <\/jats:sec>\n                <\/jats:sec>","DOI":"10.64898\/2026.01.15.26344218","type":"posted-content","created":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T03:15:12Z","timestamp":1768619712000},"source":"Crossref","is-referenced-by-count":0,"title":["Association of GLP-1 Receptor Agonist Prescriptions and Alcohol Consumption in the National Institutes of Health\u2019s\n                  <i>All of Us<\/i>\n                  Cohort"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5514-4149","authenticated-orcid":false,"given":"Benjamin","family":"Tyndall","sequence":"first","affiliation":[{"name":"RTI International, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2038-2272","authenticated-orcid":false,"given":"Angela","family":"Gasdaska","sequence":"additional","affiliation":[{"name":"RTI International, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8095-547X","authenticated-orcid":false,"given":"M. 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