Diabetes, weight-loss drug semaglutide linked to fewer asthma exacerbations

Research presented at the European Respiratory Society Congress in Barcelona, Spain, has found that semaglutide, a glucagon-like peptide-1 receptor agonist used to treat type 2 diabetes and obesity, may also reduce asthma attacks by up to 40 per cent

Semaglutide – marketed worldwide as Ozempic and Wegovy – and widely used to treat type 2 diabetes (T2DM) and in weight loss has been shown to 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 UK’s National Heart and Lung Institute, Imperial College London, UK.

“Glucagon-like peptide-1 (GLP-1) receptor agonists are widely used to treat T2DM and obesity. Previous research suggests that they may have anti-inflammatory effects and may improve lung-related outcomes.

“However, asthma and chronic obstructive pulmonary disease (COPD) outcomes have not been included as outcomes in GLP-1 drug trials.

“We wanted to use real-world [evidence] health records to investigate whether people with asthma or COPD who started GLP-1 receptor agonists had fewer acute respiratory attacks,” said Professor Bloom.

Examining UK electronic medical records, the researchers conducted four parallel studies, each of which looked at between 20,000 and 22,000 people who had started taking either a GLP-1 treatment or a different class of diabetes medication called sulfonylureas.

The team found that people with airways diseases such as asthma and COPD who had been prescribed GLP-1 therapies appeared to have fewer asthma attacks and COPD flare-ups than similar people who had been prescribed other diabetes medicines.

“The effect was strongest with semaglutide, especially in people with asthma, where use of semaglutide appears to be associated with nearly 40 per cent reduction in asthma attacks. Semaglutide also led to a 20 per cent reduction in COPD flare ups,” explained Professor Bloom.

She believes that for people with airways disease who are already eligible for GLP-1 receptor agonists because of obesity or T2DM, the results suggest these treatments may offer additional respiratory benefits.

“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,” Bloom explained.

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, said: “Obesity and metabolic dysfunction are common in airways disease and are often under-recognised 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 personalised approach to managing airways disease,” he added.

Mathioudakis was not directly involved in the research.

For further reading please see: European Respiratory Society Congress; abstract no: OA5561 – ‘The differential effects of GLP-1 based therapies in airways disease’.