22 February 2023

New approach to support successful smoking cessation

Results from a large randomised trial show that the appetite inhibitor dulaglutide can reduce weight gain after smoking cessation. This is good news for anyone who wants to quit smoking.

Quitting smoking is very difficult for many. Even for smokers who participate in cessation programs and take advantage of drug therapies the success rate is only around 30%. The biggest hurdles include craving for cigarettes, on the one hand, and the weight gain that typically accompanies smoking cessation, on the other. Both issues were investigated using a new treatment approach in a clinical study. Now the results of this study conducted by a research team around Sophia Lengsfeld and Bettina Winzeler have been published in an article in the journal eClinicalMedicine (Part of The Lancet Discovery Science).

The active substance

Dulaglutide (Trulicity^®) belongs to the class of glucagon-like peptide-1 (GLP-1) analogues which have effects on appetite regulation and are successfully used for weight reduction in overweight individuals. Animal studies also show that these compounds could play an important role in a wide range of addictions by influencing cravings for alcohol, nicotine or cocaine.

Combined approach

In the present study participants received standard smoking cessation treatment at the smoking cessation clinic at the University Hospital of Basel and, in addition, either dulaglutide or placebo for 12 weeks. While there was no difference in abstinence rates between the two treatment groups, there was a significant difference in weight change between the two groups of nearly 3 kilograms. Dulaglutide treatment also had a positive effect on blood glucose metabolism, resulting in a reduction in long-term blood glucose. The most common side effects were gastrointestinal in nature and occurred more often in the dulaglutide group.

Perspective

Although dulaglutide had no effect on abstinence rates, GLP-1 analogues may represent an important pillar in smoking cessation treatment in the future because of their beneficial metabolic effects on weight and blood glucose. For smokers the prospect of regulated weight progression during smoking cessation could be particularly motivating.