Background: Tirzepatide, already approved for weight management and diabetes treatment, is a GLP-1/GIP receptor agonist with potential for metabolic improvement. ## Study Design: A Phase 2 clinical trial sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) will evaluate tirzepatide in patients aged 21 and older with AUD and metabolic alcohol-related liver disease. The study involves a once-weekly subcutaneous injection for 12 weeks, compared to a placebo group. Primary endpoints include reduction in alcohol consumption and changes in liver fibrosis markers measured by FibroScan, with secondary assessments including cardiac function and brain/liver imaging. The study is currently recruiting and commenced on June 11, 2026. ## Expected Outcomes: Tirzepatide may reduce liver fat accumulation through weight loss and improved insulin sensitivity. Simultaneous reduction in alcohol consumption and inhibition of liver fibrosis could significantly improve patient compliance and long-term survival rates. ## Market and Clinical Significance: The global market for alcohol-related liver disease treatment is worth billions of dollars, with few approved therapies. Multi-acting agents like tirzepatide can expand treatment options and provide pharmaceutical companies with new indications, creating a driver for revenue growth. Successful clinical results will also provide a positive signal for expanding the indications of other GLP-1/GIP receptor agonists.