Tirzepatide reduced alcohol use in three patients with alcohol-associated liver disease, type 2 diabetes, and obesity

Summary: We report three obese patients with type 2 diabetes and alcohol-associated liver disease (ALD), including one patient with alcohol use disorder, who exhibited reduced alcohol intake after the initiation of tirzepatide. Although tirzepatide has shown beneficial effects on liver fibrosis in metabolic dysfunction-associated steatohepatitis, its effect on ALD or alcohol intake has not been reported. After the initiation of tirzepatide, all patients demonstrated decreased alcohol consumption, improved liver function, and better metabolic control. These findings suggest that tirzepatide can provide additional benefits for ALD by reducing alcohol intake while improving metabolic risk factors, potentially offering a novel therapeutic option for this high-risk population. Learning points: The interaction between alcohol consumption and metabolic risk factors in liver disease is bidirectional, necessitating concurrent improvement of both aspects. Treatment with tirzepatide for type 2 diabetes was associated with reduced alcohol consumption in our cases. Tirzepatide might represent an optimal therapeutic option for patients with alcohol-associated liver disease and type 2 diabetes given its potential to reduce alcohol consumption and ameliorate metabolic risk factors.