USA: GLP-1R Agonists in Asthma and Type 2 Diabetes

The administration of GLP-1R agonists in adults with asthma and type 2 diabetes results in lower counts of asthma exacerbations versus other drugs initiated for treatment intensification, finds a recent study.

The findings of the study, published in the American Journal of Respiratory and Critical Care Medicine, imply that GLP-1R agonists could be a novel treatment for asthma associated with metabolic dysfunction.

GLP-1R (glucagon-like peptide-1 receptor) agonists are approved for the treatment of diabetes and obesity. In preclinical models, they are shown to reduce airway inflammation and hyperresponsiveness. Katherine N. Cahill, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, and colleagues, therefore, aimed to compare rates of asthma exacerbations and symptoms between adults with type 2 diabetes and asthma prescribed GLP-1R agonists and those prescribed SGLT-2 (sodium–glucose cotransporter-2) inhibitors, DPP-4 (dipeptidyl peptidase-4) inhibitors, sulfonylureas, or basal insulin for diabetes treatment intensification.

For this purpose, the researchers performed an electronic health records–based new-user, active-comparator, retrospective cohort study of patients with type 2 diabetes and asthma newly prescribed GLP-1R agonists or comparator drugs at an academic healthcare system from January 2000 to March 2018.

The primary outcome was asthma exacerbations; the secondary outcome was encounters for asthma symptoms.

Key Findings of the Study

• Patients initiating GLP-1R agonists (n = 448), SGLT-2 inhibitors (n = 112), DPP-4 inhibitors (n = 435), sulfonylureas (n = 2,253), or basal insulin (n = 2,692) were identified.
• At 6 months, asthma exacerbation counts were lower in persons initiating GLP-1R agonists (reference) compared with SGLT-2 inhibitors (incidence rate ratio [IRR], 2.98), DPP-4 inhibitors (IRR, 2.45), sulfonylureas (IRR, 1.83), and basal insulin (IRR, 2.58).
• Healthcare encounters for asthma symptoms were also lower among GLP-1R agonist users.

"Adult patients with asthma prescribed GLP-1R agonists for type 2 diabetes had lower counts of asthma exacerbations compared with other drugs initiated for treatment intensification," wrote the authors. "GLP-1R agonists may represent a novel treatment for asthma associated with metabolic dysfunction."

Reference

The study titled, "Asthma Exacerbations in Patients with Type 2 Diabetes and Asthma on Glucagon-like Peptide-1 Receptor Agonists," is published in the American Journal of Respiratory and Critical Care Medicine.

DOI: https://www.atsjournals.org/doi/abs/10.1164/rccm.202004-0993OC