GLP-1 and SGLT-2 drugs may be the best treatments for people with type 2 diabetes and COPD.
- Researchers estimate the number of
people globally living with chronic obstructive pulmonary disease (COPD)
will hit 600 million by 2050.
- There are certain risk factors for
COPD, including obesity and having type 2 diabetes.
- A new study has found that people who have type 2 diabetes who are treated with GLP-1 and SGLT-2 medications have a lower risk of having COPD symptom flare-ups than those taking DPP-4 drugs.
Researchers estimate that as of 2019, about 400
million people around the world were living with chronic obstructive pulmonary disease (COPD), with that number expected to hit
600 million by 2050.
While anyone might develop COPD,
there are certain risk factors that may increase a person’s chance of developing
this chronic disease, including smoking, age, genetics, long-term exposure to environmental
hazards like air pollution and dust, as well as certain conditions such
as obesity and type 2 diabetes.
Past research shows that more
than one-third of
people who have COPD also
have obesity, as this condition may have a negative impact on a person’s airflow and thus
increase their risk for respiratory tract infections, obstructive sleep apnea, pulmonary hypertension, pulmonary embolism, and obesity hypoventilation syndrome.
A study published in May 2023 further
found that people who have type 2 diabetes have a 35% higher riskTrusted Source of developing COPD than someone who
does not.
Now, a new study published in JAMA Internal MedicineTrusted Source reports that people who have
type 2 diabetes and are treated with sodium-glucose cotransporter-2
inhibitors (SGLT-2is)Trusted
Source or glucagon-like peptide-1 receptor
agonists (GLP-1RAs) —
like Ozempic and Wegovy — may be at a lower risk of
moderate or severe COPD exacerbations, or symptom flare-ups, compared to those taking dipeptidyl peptidase 4 inhibitors
(DPP-4is)Trusted Source.
COPD risks: Why focus on GLP-1 and other diabetes medications?
For this study, researchers analyzed
medical data from almost 394,000 adults 40 years and older with type 2 diabetes
and active COPD that were taking GLP-1, SGLT-2, or DPP-4i medications.
Elisabetta Patorno, MD, DrPH, associate professor of medicine at
Harvard Medical School, associate professor in the Department of Epidemiology
at the Harvard T.H. Chan School of Public Health, and director of the Program
on the Pharmacoepidemiology of Cardiovascular-Kidney-Metabolic Diseases
(PROMISE) at the Division of Pharmacoepidemiology at Brigham and Women’s
Hospital in Boston, senior author of this study, told Medical News
Today:
“We explored the link between GLP-1,
SGLT-2i medications, and COPD exacerbation risk because prior research
suggested these drugs might have anti-inflammatory and lung-protective effects.
However, there was limited clinical evidence comparing their impact on COPD
outcomes in patients with type 2 diabetes.”
“Researchers continue studying GLP-1
medications beyond diabetes and weight loss because they may have additional
health benefits, such as reducing inflammation, improving lung function, and
lowering the risk of conditions like COPD exacerbations,” added Avik Ray, MD,
MS, research fellow
at the Division of Pharmacoepidemiology at Brigham and Women’s Hospital and
Harvard Medical School, first author of this study.
“Understanding these effects can help
patients with these conditions,” he added.
GLP-1s, SGLT-2s linked to lower risk of COPD flare-ups
At the conclusion of the study,
researchers found that study participants with both type 2 diabetes and COPD
who took GLP-1 or SGLT-2 medications had a lower risk of having moderate or
severe COPD exacerbations when compared to participants taking DPP-4i drugs.
“The finding that SGLT-2i and
GLP-1RAs lower COPD exacerbation risk compared to DPP-4i suggests these
medications could be better options for patients with diabetes and COPD,”
Patorno said. “This could influence treatment decisions and improve respiratory
health in this high-risk population.”
“GLP-1 medications might help lower COPD
exacerbation risk by reducing systemic inflammation, improving metabolic function, and
possibly having direct effects on lung tissue,” she continued. “Their impact on
weight loss and cardiovascular health could also contribute to better overall
respiratory outcomes.”
“These findings may encourage doctors
to prioritize SGLT-2i or GLP-1RAs over DPP-4i for patients with type 2 diabetes
and COPD,” Ray said. “By considering the added respiratory benefits, physicians
can optimize treatment choices for both diabetes and lung health.”
“The next steps [for this research]
include conducting further research to confirm these findings in other
real-world datasets, exploring the biological mechanisms behind these benefits,
and assessing the long-term impact of these medications on COPD progression,”
he added.
Long-term safety data
needed
MNT had the opportunity to speak
with Fady Youssef,
MD, a
board-certified pulmonologist, internist and critical care specialist at
MemorialCare Long Beach Medical Center in Long Beach, CA, about this study.
Youssef commented that it is known
that obesity affects lung function and does make obstructive lung disease such
as COPD and asthma much more difficult to control, and so it is not yet clear
if the effect of the drug had to do with the weight loss and its effect on
COPD, or it had a different mechanism of action.
“There’s a lot of hype and excitement
around GLP-1 and like medications,” Youssef. “And the thing I want to see is
long-term safety data. Whenever we give medication to a large portion of the
population without long-term safety, one is concerned about what those
long-term safety signals are going to be.”
“COPD exacerbations carry significant
morbidity and significant cost of the healthcare system, and so I would like to
see data to prevent, to figure out how we can minimize the incidence of COPD as
a new patient developing COPD,” he added. “And if we can’t prevent it from
happening, figuring out control and minimizing exacerbations.”
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