Taking a GLP-1 receptor agonist — a group of type 2 diabetes drugs that includes Byetta and Bydureon (exenatide), Ozempic (semaglutide), Trulicity (dulaglutide), and Victoza (liraglutide) — is linked to fewer asthma attacks in people with both type 2 diabetes and asthma, according to a new study published in the American Journal of Respiratory and Critical Care Medicine.
As the researchers wrote in the article, GLP-1 receptor agonist have been linked to reductions in airway inflammation and hyperresponsiveness — two hallmarks of asthma — in preclinical (usually animal) studies. The researchers were interested in finding out whether these drugs offer the same benefit in people with asthma, even though these drugs aren’t taken to treat asthma. So they looked at a database of 5,940 adults with type 2 diabetes and asthma who were newly prescribed either a GLP-1 agonist or another drug to intensify their diabetes treatment between January 2000 and March 2018.
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As noted in a Healio article on the study, the main outcome researchers were interested in was asthma exacerbations (attacks), in addition to encounters with the healthcare system for asthma symptoms. A total of 448 people — mostly women (72%), with an average age of 54 — took a GLP-1 receptor agonist in the study database. Another 112 took an SGLT2 inhibitor, 435 took a DPP-4 inhibitor, 2,253 took a sulfonylurea, and 2,692 took basal (long-acting) insulin.
Fewer asthma attacks in those taking a GLP-1 receptor agonist
After six months, people who took a GLP-1 receptor agonist tended to have a lower count of asthma attacks than people who took any of the other drugs for diabetes treatment intensification. Compared with people who took a GLP-1 receptor agonist, the average number of asthma attacks per person was 2.98 times as high for SGLT2 inhibitors, 2.45 times as high for DPP-4 inhibitors, 1.83 times as high for sulfonylureas, and 2.58 times as high for basal insulin. There were also fewer healthcare encounters for asthma symptoms, on average, for people who took a GLP-1 receptor agonist. These findings remained significant even after the researchers adjusted for differences in blood glucose control and weight loss during the six-month period.
As noted in the Healio article, these findings support the earlier findings indicating that GLP-1 plays a role in lung function, airway inflammation, or both. This may be true for inflammation caused by either allergies or a viral infection, according to one of the study authors.
GLP-1 receptor agonists “may represent a novel treatment for asthma associated with metabolic dysfunction,” the researchers concluded. More research is needed, though, before any official recommendations can be made about prescribing GLP-1 receptor agonists as part of an asthma treatment strategy in people with type 2 diabetes.
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