Novo's Ozempic May Lower Opioid Overdose Risk in Diabetics

A recent retrospective cohort study examining over 33,000 patients with type 2 diabetes revealed that Novo Nordisk's GLP-1 medication, Ozempic (semaglutide), can potentially reduce the risk of opioid overdose by 42% to 68%. This finding was published in JAMA Network Open and offers new insights into the benefits of semaglutide beyond its primary use as a diabetes treatment.

The research utilized the TriNetX Analytics Platform to analyze electronic health records of patients who had both type 2 diabetes and opioid use disorder. Out of the total participants, over 3,000 were treated with semaglutide, while the rest were administered other anti-diabetic medications such as insulin, metformin, and liraglutide. The study employed propensity-score matching to ensure that participants were balanced in terms of age, sex, ethnicity, and other comorbidities.

Results indicated that patients on semaglutide had a significantly reduced risk of opioid overdose compared to those on other diabetes treatments. Specifically, semaglutide reduced the risk of overdose by 58% compared to insulin and by 54% relative to metformin. The risk reduction was even more pronounced when semaglutide was compared to thiazolidinediones and dipeptidyl peptidase-4 inhibitors, with reductions of 68% and 63%, respectively. Additionally, semaglutide exhibited a 55% reduction in the risk of opioid overdose compared to liraglutide, another GLP-1 therapy.

The only anti-diabetic drug where semaglutide did not show a statistically significant advantage was Eli Lilly's Trulicity (dulaglutide). Despite the promising data, the study's authors recognized several limitations, including potential unmeasured and uncontrolled confounders and other biases inherent in observational studies. They emphasized the need for further validation through additional data sources and study populations. Moreover, the researchers called for more studies to explore the underlying mechanisms by which semaglutide affects opioid use, as well as clinical trials to better confirm its clinical benefits in this patient population.

This study adds to the growing body of evidence supporting the multifaceted benefits of semaglutide and other GLP-1 treatments. Recently, a publication in JAMA Internal Medicine suggested that these incretin therapies might assist patients with metabolic dysfunction-associated steatotic liver disease in reducing their risk of progressing to cirrhosis and its associated complications.

Additionally, in July 2024, a separate study published in the Annals of Internal Medicine demonstrated that semaglutide might reduce tobacco use disorder in diabetes patients. Furthermore, a Phase II study indicated that GLP-1 therapies could offer cognitive benefits in neurodegenerative disorders, showing that patients with Alzheimer's disease on liraglutide experienced slower cognitive decline compared to those on a placebo.

The findings of this study could have significant implications for the treatment of patients with type 2 diabetes who are also struggling with opioid use disorder, highlighting an additional therapeutic benefit of semaglutide and potentially broadening its use in clinical practice.