GLP-1 drugs could help with smoking cessation

In a new study published in the Annals of Internal Medicine, researchers found that patients with type 2 diabetes and tobacco use disorder (TUD) who used the GLP-1 drug semaglutide, also known as Ozempic and Wegovy, were less likely to need medical care for TUD than those who used other diabetes drugs.

For the study, researchers emulated seven target trials among 222,942 eligible patients with type 2 diabetes and TUD. The researchers compared the use of semaglutide to other diabetes medications, including insulins, metformin, and other GLP-1 drugs, such as dulaglutide (Trulicity) and liraglutide (Saxenda, Victoza).

Overall, there were 5,967 patients in the semaglutide group and 216,975 patients in other medication groups. Among the patients, the mean age was 59 years, and 69% were white.

The researchers found that patients on semaglutide had a reduced risk of medical encounters for a TUD diagnosis compared to patients taking insulin medications. These patients were also less likely to need prescriptions for smoking cessation medications and counseling for smoking cessation.

Patients also reported that they had a "reduced desire to smoke" while taking semaglutide, which the researchers said lent support for the drug being used a smoking cessation tool. Other early research has also suggested that GLP-1 drugs may help with addictive behavior, including for alcohol, cannabis, and more.

"The fact that semaglutide (and other GLP-1 receptor agonists) leads to weight loss becomes particularly relevant because smoking cessation is associated with weight gain, which contributes to relapse, particularly in women," the researchers wrote. "Moreover, because smoking impairs glycemic control and increases cardiovascular and cancer risks, the beneficial effects of semaglutide for glycemic control, and reduction in cardiovascular and cancer events, would offer additional benefits."

However, the researchers also emphasized that the study's findings "should not be interpreted to justify clinicians' use of semaglutide off-label for smoking cessation. This will need to be examined in randomized clinical trials."

Older GLP-1 drugs may protect against Alzheimer's

In a separate study, researchers from Imperial College London tested the effects of liraglutide in patients with early Alzheimer's disease over one year. Liraglutide is an earlier GLP-1 drug made by Novo Nordisk, the manufacturer of Ozempic and Wegovy.

In the Phase 2 randomized trial, researchers enrolled 204 patients across different sites in the United Kingdom. The patients did not have either diabetes or obesity.

Although the trial didn't meet its primary endpoint, the researchers found that there were statistically significant differences among patients who took liraglutide and those who didn't on other outcomes. For example, patients on liraglutide had almost 50% less shrinkage in areas of the brain associated with cognitive function, such as the frontal, temporal, and parietal areas.

"The slower loss of brain volume suggests liraglutide protects the brain, much like statins protect the heart," said Paul Edison, a professor of neuroscience and medicine at Imperial College London and the trial's lead researcher.

Patients who took liraglutide also had an 18% slower decline in cognitive function as measured by the ADAS EXEC z score, which is a composite score of 18 different memory, comprehension, language, and spatial orientation tests.  

"Repurposing drugs already approved for other conditions has the advantage of providing data and experience from previous research and practical use—so we already know a lot about real-world effectiveness in other diseases and side effects," said Maria Carrillo, chief science officer and medical affairs lead for the Alzheimer's Association.

"We are in an era of unprecedented promise, with new treatments in various stages of development that slow or may possibly prevent cognitive decline due to Alzheimer's disease," Carillo added.

Advisory Board's weight-related resources

To help you address the growing use of weight management drugs, Advisory Board offers several resources:

This expert insight outlines the five biggest questions about weight management drugs and their answers. Similarly, this expert insight addresses what headlines get wrong about weight management drugs and what healthcare leaders should know instead.

Radio Advisory's Rachel Woods has also covered GLP-1 drugs on the podcast, discussing the potential future of these drugs and how they could help — or hurt — health systems' finances. Other useful resources include this expert insight on the five catalysts that will impact the future of obesity care and this research on three potential pathways for the future of obesity care.

Our weight management and obesity care resource library can also help leaders understand the current care landscape, manage innovations, and prepare for transformations in care. (Short, MedPage Today, 7/30; Hart, Forbes, 7/30; Chen, STAT+ [subscription required], 7/30; Hart, Forbes, 7/30)