Association of Semaglutide With Tobacco Use Disorder in Patients With Type 2 Diabetes : Target Trial Emulation Using Real-World Data.
Ann Intern Med
; 177(8): 1016-1027, 2024 Aug.
Article
em En
| MEDLINE
| ID: mdl-39074369
ABSTRACT
BACKGROUND:
Reports of reduced desire to smoke in patients treated with semaglutide, a glucagon-like peptide receptor agonist (GLP-1RA) medication for type 2 diabetes mellitus (T2DM) and obesity, have raised interest about its potential benefit for tobacco use disorders (TUDs).OBJECTIVE:
To examine the association of semaglutide with TUD-related health care measures in patients with comorbid T2DM and TUD.DESIGN:
Emulation target trial based on a nationwide population-based database of patient electronic health records.SETTING:
United States, 1 December 2017 to 31 March 2023.PARTICIPANTS:
Seven target trials were emulated among eligible patients with comorbid T2DM and TUD by comparing the new use of semaglutide versus 7 other antidiabetes medications (insulins, metformin, dipeptidyl-peptidase-4 inhibitors, sodium-glucose cotransporter-2 inhibitors, sulfonylureas, thiazolidinediones, and other GLP-1RAs). MEASUREMENTS The TUD-related health care measures (medical encounter for diagnosis of TUD, smoking cessation medication prescriptions, and smoking cessation counseling) that occurred within a 12-month follow-up were examined using Cox proportional hazards and Kaplan-Meier survival analyses.RESULTS:
The study compared 222 942 new users of antidiabetes medications including 5967 of semaglutide. Semaglutide was associated with a significantly lower risk for medical encounters for TUD diagnosis compared with other antidiabetes medications, and was strongest compared with insulins (hazard ratio [HR], 0.68 [95% CI, 0.63 to 0.74]) and weakest but statistically significant compared with other GLP-1RAs (HR, 0.88 [CI, 0.81 to 0.96]). Semaglutide was associated with reduced smoking cessation medication prescriptions and counseling. Similar findings were observed in patients with and without a diagnosis of obesity. For most of the group comparisons, the differences occurred within 30 days of prescription initiation.LIMITATION:
Documentation bias, residual confounding, missing data on current smoking behavior, body mass index, and medication adherence.CONCLUSION:
Semaglutide was associated with lower risks for TUD-related health care measures in patients with comorbid T2DM and TUD compared with other antidiabetes medications including other GLP-1Ras, primarily within 30 days of prescription. These findings suggest the need for clinical trials to evaluate semaglutide's potential for TUD treatment. PRIMARY FUNDING SOURCE National Institutes of Health.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tabagismo
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Diabetes Mellitus Tipo 2
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Peptídeos Semelhantes ao Glucagon
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Hipoglicemiantes
Limite:
Aged
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Ann Intern Med
Ano de publicação:
2024
Tipo de documento:
Article
País de publicação:
Estados Unidos