Semaglutide May Help Smokers Quit, Study Suggests

Among patients with type 2 diabetes and tobacco use disorder (TUD), use of the GLP-1 receptor agonist semaglutide (Ozempic, Wegovy) was associated with a reduced risk of medical complications. for TUD compared to other diabetes medications, according to the objective of the simulation. test.

Using a national public database of electronic health records, the strongest association with reduced risk of medical contact for TUD diagnosis, smoking cessation medication prescriptions, and counseling of smoking cessation was observed when semaglutide was compared with insulins (HR 0.68, 95% CI). 0.63-0.74), reports Nora D. Volkow, MD, director of the National Institute on Drug Abuse, and colleagues.

The association was weaker, but still statistically significant, when semaglutide was compared with other GLP-1 drugs (HR 0.88, 95% CI 0.81-0.96), they noted Annals of Internal Medicine.

Findings were consistent across obese and nonobese patients, and differences occurred within 30 days of prescription initiation for multiple group comparisons.

Patients taking semaglutide report having “reduced desire to smoke,” lending support for the drug as a smoking cessation tool, Volkow and colleagues say.

They pointed to a recent cohort study showing that semaglutide was associated with reduced incidence and relapse of cannabis-use disease, as well as a small pilot trial in patients those with obesity or prediabetes who have shown exenatide (Byetta, Bydureon) in combination with nicotine replacement therapy. improved smoking cessation compared to placebo.

“The fact that semaglutide (and other GLP-1 receptor agonists) lead to weight loss is particularly important because smoking cessation is associated with weight gain, which contributes to relapse, especially in women,” Volkow’s team wrote. “Furthermore, because smoking impairs glycemic control and increases cardiovascular and cancer risks, the beneficial effects of semaglutide for glycemic control, and reducing cardiovascular and cancer events, may provide additional benefits. “

Semaglutide also has a higher adherence rate than other medications, including other GLP-1 drugs, in patients with type 2 diabetes, they added.

For this study, seven randomized controlled trials were conducted among 222,942 patients with type 2 diabetes and TUD comparing the new use of semaglutide (n = 5,967) versus other medications. of diabetes (n = 216,975), including insulins, metformin, DPP-4 inhibitors. SGLT2 inhibitors, sulfonylureas, thiazolidinediones and other GLP-1 agonists (albiglutide). [Tanzeum]dulaglutide [Trulicity]exenatide, liraglutide [Saxenda, Victoza]and lixisenatide [Adlyxin]).

Eligible patients had a medical appointment with a health care organization from December 2017 through March 2023; diagnosis of type 2 diabetes and TUD before the index event (medical appointments for TUD diagnosis, smoking cessation medication prescriptions, and smoking cessation counseling); and screening for obesity, hypertension, hypercholesterolemia, hyperlipidemia, heart disease, or stroke before the index event.

Patients were excluded if they had used diabetes medication in the year before the index event; history of bariatric surgery, pancreatitis, type 1 diabetes, thyroid cancer, or gastroparesis; or co-prescriptions of semaglutide and other diabetes medications on the day of the index event.

Patients were followed from the index event until the occurrence of measurement, death, loss to follow-up, or 12 months after the index event, whichever occurred first.

After comparing the rate data for the semaglutide and insulin groups, the mean age at the index event was 59, and women made up half of each group. The majority of patients were white (69%), 11.8% were black, and about 4% were Asian.

Among non-obese patients, semaglutide was associated with a significantly lower risk of medical contact for TUD diagnosis compared with other diabetes medications, with risk ratios ranging from 0.60 for insulin (95% CI 0.51-0.71) to 0.78 for thiazolidinediones (95% CI 0.64). -0.94), without other GLP-1 drugs (HR 0.85, 95% CI 0.71-1.02).

Among patients with a prior diagnosis of obesity, semaglutide was associated with a significantly lower risk of medical contact for TUD diagnosis compared to all other included diabetes medications.

In addition, semaglutide was associated with a significantly lower risk of prescription for smoking cessation medications compared to other diabetes medications, with the strongest association when compared to insulins (HR 0.32, 95% CI 0.28-0.38) and significantly less compared to other GLP-1 drugs (HR 0.62, 95% CI 0.52-0.74). This association was observed regardless of obesity.

Semaglutide was also associated with a lower risk of smoking cessation counseling, and was significant compared to insulins, metformin, and DPP-4 inhibitors, with risk ratios ranging from 0.69 to 0.85.

Volkow and colleagues listed the study’s retrospective, prospective design among its key limitations. Other limitations included the short follow-up period, limited sample size for comparison with other anti-obesity medications, and missing data on medication adherence.

They also emphasized that this study was the first to use semaglutide for smoking cessation and the results “should not be interpreted to justify the off-label use of semaglutide for smoking cessation.” stop smoking. This will need to be tested in unusual medicines.”