Association of GLP-1 Receptor Agonists with Chronic Obstructive Pulmonary Disease Exacerbations among Patients with Type 2 Diabetes

A Daunting and Challenging Task to Prove the Effectiveness of Reducing Acute Exacerbation in COPD Patients with Type 2 Diabetes by GLP-1 Receptor Agonists

“…In conclusion, despite some remaining limitations, it is undeniable that Foer and colleagues’ study ( 4 ) provides informative value for the selection of treatment regimens for patients with COPD and T2D and obesity. In the future, it is necessary to conduct a multicenter, randomized, double-blind, placebo-controlled trial of GLP-1RAs in patients with COPD and comorbid T2D.…”

“…In a recent issue of the Journal , the findings of Foer and colleagues fill the research gap in this field ( 4 ). They retrospectively compared GLP-1RAs with other T2D drugs to identify an association of GLP-1RA therapy and acute COPD exacerbation among patients with T2D.…”

“…They retrospectively compared GLP-1RAs with other T2D drugs to identify an association of GLP-1RA therapy and acute COPD exacerbation among patients with T2D. Considering various confounding factors, the investigators proposed a “clinical model” and a “metabolic model,” conducted a multilevel analysis, and demonstrated that risks of exacerbation were significantly decreased among GLP-1RA users compared with users of sulfonylurea and DPP-4 (dipeptidyl peptidase 4) inhibitors ( 4 ). We extend our sincere congratulations to the authors for elucidating this association, which will provide a reference for the selection of treatment options for patients with comorbid COPD and T2D.…”

“…However, to prove the effectiveness of reducing acute exacerbation in patients with COPD and T2D with GLP-1RAs is a daunting and challenging task, and there are several problems with Foer and colleagues’ retrospective study. First of all, after stratification by body mass index (BMI), only the obese group showed a significant effect of GLP-1RAs in reducing acute exacerbations of COPD ( 4 ). Therefore, whether the effectiveness of reducing acute exacerbation in patients with COPD and T2D with GLP-1RAs is applicable to all populations needs to be further explored.…”

Reply to Li et al.

“…We appreciate the close reading of our recent paper ( 1 ) by Li and colleagues and their shared interest in the GLP-1R (glucagon-like peptide-1 receptor) pathway in obstructive respiratory disease. They correctly note that our retrospective cohort included patients across the body mass index (BMI) spectrum and with a range chronic obstructive pulmonary disease (COPD) severity.…”