GLP-1 treatment linked to 40% fewer asthma attacks

The diabetes and weight loss injection semaglutide can reduce asthma attacks by up to 40 per cent according to research presented at the European Respiratory Society (ERS) Congress in Barcelona, Spain.

The study was led by Professor Chloe Bloom, Clinical Associate Professor in Respiratory Epidemiology at the National Heart & Lung Institute, Imperial College London, UK, and presented by Dr Bohee Lee.

GLP-1 receptor agonists are widely used to treat type 2 diabetes and obesity. Previous research suggests that they may have anti-inflammatory effects and may improve lung-related outcomes. However, asthma and COPD outcomes have not been included as outcomes in GLP-1 drug trials.

We wanted to use real-world health records to investigate whether people with asthma or COPD who started GLP-1 receptor agonists had fewer acute respiratory attacks."

Professor Chloe Bloom, Clinical Associate Professor in Respiratory Epidemiology, National Heart & Lung Institute, Imperial College London, UK

Using UK electronic medical records, the researchers conducted four parallel studies that each looked at between 20,000 and 22,000 people who started taking any type of GLP-1 treatment or another type of diabetes medication called sulfonylureas.

They found that people with airways diseases like asthma and COPD who were prescribed GLP-1 therapies appeared to have fewer asthma attacks and COPD flare ups than similar people who were prescribed other diabetes medicines.

Bloom explains: "The effect was strongest with semaglutide especially in people with asthma, where use of semaglutide appears to be associated with nearly 40% reduction in asthma attacks. Semaglutide also led to a 20% reduction in COPD flare ups."

She believes that for people with airways disease who are already eligible for GLP-1 receptor agonists because of obesity or type 2 diabetes, the results suggest these treatments may have additional respiratory benefits.

She explains: "The findings from this study are encouraging, but they should not change treatment decisions on their own. People with asthma or COPD should not start GLP-1 receptor agonists specifically for their lung condition outside current prescribing guidance. While the findings suggest that some people taking GLP-1 receptor agonists may experience fewer respiratory attacks, this needs confirmation in clinical trials."

Dr Alexander Mathioudakis, Chair of the European Respiratory Society's Group on Airway Pharmacology and Treatment and Senior Lecturer in Respiratory Medicine at the University of Manchester, UK, who was not involved in the research said: "Obesity and metabolic dysfunction are common in airways disease and are often under-recognized as problems that can and should be addressed.

"This is one of the largest real-world studies to investigate GLP-1 receptor agonists and airways disease, and one of the first to examine whether effects differ between individual GLP-1 receptor agonists.

"It highlights the need to consider metabolic health as part of respiratory care. It also supports the case for including respiratory outcomes, such as asthma attacks and COPD exacerbations, in future trials of metabolic therapies.

"We need clinical trials that include respiratory outcomes, such as asthma attacks, COPD exacerbations, lung function, symptoms and quality of life, to determine whether metabolic treatments could become part of a broader, more personalized approach to managing airways disease."