Postdoctoral Fellow University of Ottawa Heart Institute, Canada
Background: Smoking and obesity are leading risk factors of morbidity and mortality worldwide. Recent studies have demonstrated efficacy of medications like glucagon-like peptide-1 (GLP-1) receptor agonists to reduce weight and improve clinical outcomes. There is also potential for GLP-1 receptor agonists to address addiction. Despite smoking cessation efforts, relapse rates are high, and current treatments are often inadequate. This systematic review examines the emerging potential of GLP-1 receptor agonists in smoking cessation.
METHODS AND RESULTS: We conducted a systematic review and meta-analysis following PRISMA guidelines to assess the efficacy of GLP-1 receptor agonists for smoking cessation. Random-effects models were used for pooled analysis of randomized controlled trials, with data extracted from PubMed, Scopus, Cochrane Library, and Web of Science. The initial search yielded 514 records, of which 26 full-text articles were reviewed, of which two randomized controlled trials with 339 patients were included for extraction. There was no significant effect of GLP-1 agonists on smoking cessation (OR 1.36, 95% CI: 0.55, 3.35, p=0.51) and there was high heterogeneity (I² = 66.93). A dose-response analysis suggested a potential positive effect of higher doses on abstinence.
Conclusion: While GLP-1 agonists have revolutionized care for patients with diabetes and obesity, there are few studies assessing their efficacy for smoking cessation. This meta-analysis did not demonstrate a significant impact of GLP-1 agonists on smoking cessation. More research, especially using newer and more commonly used agents, are needed to assess their impact on smoking cessation and mitigating post-cessation weight gain.
