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Association of Semaglutide With Tobacco Use Disorder in Patients With Type 2 Diabetes : Target Trial Emulation Using
William Wang1, Nora D Volkow2, Nathan A Berger1
1Center for Science, Health, and Society, Case Western Reserve University School of Medicine, Cleveland, Ohio (W.W., N.A.B.).
Semaglutide, used for type 2 diabetes and obesity, was linked to fewer tobacco use disorder healthcare visits and less smoking cessation support. Further trials are needed to confirm its role in treating smoking addiction.
Area of Science:
- Pharmacology
- Public Health
- Addiction Medicine
Background:
- Semaglutide, a GLP-1RA, is used for type 2 diabetes mellitus (T2DM) and obesity.
- Reduced smoking desire reported in patients using semaglutide suggests potential for tobacco use disorder (TUD) treatment.
Purpose of the Study:
- To investigate the association between semaglutide use and TUD-related healthcare utilization in patients with comorbid T2DM and TUD.
Main Methods:
- Emulation of target trials using a nationwide electronic health record database (US, 2017-2023).
- Comparison of semaglutide users with users of 7 other antidiabetes medication classes.
- Analysis of TUD diagnosis encounters, cessation medication prescriptions, and counseling within 12 months via survival analyses.
Main Results:
- Semaglutide use was associated with significantly lower risk of TUD diagnosis encounters compared to other antidiabetes medications, particularly insulins (HR 0.68) and other GLP-1RAs (HR 0.88).
- Reduced prescriptions for smoking cessation medications and counseling were also observed with semaglutide.
- These effects were noted within 30 days of prescription initiation and in patients with or without obesity.
Conclusions:
- Semaglutide use correlates with decreased TUD-related healthcare measures in patients with T2DM and TUD.
- Findings support further clinical trials to explore semaglutide's efficacy in treating tobacco use disorders.
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