GLP-1 Drugs Linked to Fewer Asthma, COPD Attacks in Study
A large real-world study presented at the ERS Congress found patients with asthma or COPD who started a GLP-1 drug had a 14% lower risk of severe
Patients with asthma or chronic obstructive pulmonary disease (COPD) who began taking a GLP-1 receptor agonist for a separate condition had a 14% lower risk of severe respiratory attacks compared to similar patients starting sulfonylureas. The research, based on UK electronic health records, was presented by Dr. Chloe Bloom of Imperial College London at the European Respiratory Society Congress in Barcelona.
According to the study, the reduction in exacerbations-defined as a short course of oral steroids, an emergency visit, hospitalization, or death-was not uniform across all GLP-1 drugs. The analysis showed varying levels of association.
| Drug (Brand Examples) | Reduction in Exacerbation Risk |
|---|---|
| Semaglutide (Ozempic, Wegovy) | 30% |
| Exenatide (Byetta, Bydureon) | 23% |
| Dulaglutide (Trulicity) | 12% |
| Liraglutide (Victoza, Saxenda) | No significant change |
| Lixisenatide (Adlyxin) | No significant change |
Study Details and Cautions
The observational study analyzed records from over 1.1 million adults with asthma or COPD, focusing on 8,266 new users of GLP-1 drugs and 20,273 new users of sulfonylureas. Dr. Bloom emphasized the findings should not immediately change treatment plans. "People with asthma or COPD should not start GLP-1 receptor agonists specifically for their lung condition outside current prescribing guidance," she said in a press release. She added that the results need confirmation in clinical trials.
Potential Mechanisms and Phenotypes
The effect of semaglutide appeared stronger in patients with asthma, linked to a 38% reduction in attacks, compared to a 21% reduction in those with COPD. Intriguingly, metabolic factors like body mass index, HbA1c, insulin resistance, or changes in weight and blood sugar during treatment did not seem to modify the drug's effect. "Metabolic factors did not appear to significantly influence effects, supporting the possibility of direct pulmonary mechanisms," Dr. Bloom suggested.
Expert Calls for Clinical Trials
Several independent experts stressed the study's limitations and the need for randomized controlled trials. Dr. Alexander Mathioudakis of the University of Manchester called it one of the largest real-world studies on the topic but noted the critical next step. "We need clinical trials that include respiratory outcomes, such as asthma attacks, COPD exacerbations, lung function, symptoms, and quality of life," he stated. Dr. Marie Spreckley of the University of Cambridge agreed, writing on the Science Media Centre website that it is too early to claim semaglutide prevents asthma attacks and that people should not seek it specifically for that purpose.
Interpreting the Data
Other factors like age, smoking status, and eosinophil count did not appear to modify the risk of exacerbations. Commenting on the differing results between drugs, statistician Dr. Stephen Burgess of the University of Cambridge noted it was unclear if semaglutide's stronger signal was a true specific effect or a statistical anomaly. "It may simply be that we can make a stronger claim about semaglutide because we have more data on this drug," he wrote. He added that the logical connection to weight loss made the findings heartening, even as he cautioned that clinical trials estimate average population effects rather than guaranteed individual benefit.
