A recent study found that tirzepatide and semaglutide, both glucagon-like peptide-1 (GLP-1) receptor agonists, carried comparable risks of asthma exacerbations in adults diagnosed with both asthma and type 2 diabetes (T2D).
The study, which analyzed electronic health record data from over 65 healthcare organizations in the US, found that 11% of patients receiving tirzepatide and 11.1% of patients receiving semaglutide experienced asthma flare-ups during the 12-month follow-up period.
Asthma and T2D Coexistence
Asthma and T2D often coexist, with about 13% to 16% of patients having both conditions. This coexistence is significant, as both conditions experience poorer asthma control, more severe exacerbations, and greater healthcare utilization compared to those with asthma alone.
According to Khalilah Gates, MD, a pulmonary and critical care specialist, patients with obesity who also have asthma are at increased risk for worsening asthma severity and potential reduction in response to regular asthma therapies.
GLP-1 Therapies and Asthma
GLP-1 therapies, such as semaglutide and tirzepatide, may have effects beyond weight loss and glycemic control, including reducing the risk of asthma exacerbations. Data supporting the potential respiratory effects of GLP-1-based therapies have grown in recent years, with several studies reporting better asthma outcomes among patients using these medications.
A retrospective cohort study found that GLP-1s were associated with a lower risk for asthma exacerbations than sodium-glucose cotransporter-2 (SGLT2) inhibitors. Another study involving adults with asthma and obstructive sleep apnea found GLP-1 use was associated with lower risk for asthma exacerbations, emergency department visits, and hospitalization.
Study Findings
The study analyzed data from 455,196 patients with asthma and T2D, with 8178 patients receiving tirzepatide and 28,135 patients receiving semaglutide. After propensity score matching, 8176 patients were included in each group.
Although tirzepatide and semaglutide showed similar asthma flare-up risk, tirzepatide was associated with an 8% lower risk for short-acting beta-agonist (SABA) use. However, corticosteroid use was similar between the two groups.
Khalilah Gates, MD noted that GLP-1s should be considered in patients with difficult-to-control asthma and/or asthma with frequent exacerbations and obesity, as they may benefit from the weight loss observed with these medications.
Mark Moss, MD, director of the Clinical Research Program in the Division of Allergy and Immunology at the University of Wisconsin Hospitals, emphasized that preliminary studies suggest that the benefits of GLP-1 medications may extend to asthma control, but well-designed, randomized clinical trials are needed before any firm recommendations can be made regarding their use specifically for asthma.
In comparison to other treatments, GLP-1 therapies may offer a unique benefit in reducing asthma exacerbations, particularly in patients with coexisting T2D.