The relationship between the use of GLP-1 receptor agonists and the incidence of respiratory illness: a meta-analysis of randomized controlled trials

Abstract

Aim We aimed to assess the association between the use of Glucagon-like peptide-1 receptor agonists and the risk of 12 respiratory diseases in patients with type 2 diabetes, obesity, or overweight. Method The PubMed (MEDLINE), EMBASE, Cochrane Library, and ClinicalTrials.gov databases were searched from the establishment of the database to December 24, 2022. Dichotomous outcomes were analyzed using RR and 95% CI calculated from fixed-effects models. Results Twenty-eight RCTs were ultimately included for analysis, involving a total of 77,485 participants. Compared to controls, patients with GLP-1RAs have a 14% lower risk of respiratory disease (RR 0.86, 95% CI 0.81–0.93 p < 0.0001), with Semaglutid (RR 0.82, 95% CI 0.68–0.97, p = 0.02), Liraglutide (RR 0.86. 95% CI 0.75–0.98, p = 0.03), Dulaglutide (RR 0.82, 95% CI 0.70–0.96, p = 0.02), Albiglutide (RR 0.93,95% CI 0.79–1.10, p = 0.40), Exenatide (RR 0.93, 95% CI 0.74–1.18, p = 0.55), Lixisenatide (RR 0.83, 95% CI 0.62–1.12, p = 0.22), and Efpeglenatide (RR 0.76, 95% CI 0.46–1.24, p = 0.27). Semaglutide, Liraglutide and Dulaglutide reduce the risk of respiratory diseases by 18%, 14% and 18%, respectively.Trial duration, control type, and indication were not associated with the impact of GLP-1 receptor agonists on overall respiratory disease. Among secondary outcomes, the risk of Pulmonary edema (RR 0.66, 95% CI 0.44–0.98, p = 0.04), and Bronchitis (RR 0.86, 95% CI 0.74–1.00, p = 0.04) was reduced. Conclusion In conclusion, GLP-1RAs were linked to a lower risk of overall respiratory diseases, especially Pulmonary edema and Bronchitis. In the future, physicians should pay attention to the relationship between GLP-1 RA and the risk of respiratory diseases and evaluate the efficacy of GLP-1RAs in the primary and secondary prevention of respiratory diseases. Trial registration CRD42023396138. Graphical Abstract

Potential New Therapeutic Implications of Semaglutide: New Colours of the Rainbow?

“…These findings regarding pulmonary diseases could be considered positive side effects of semaglutide, rather than therapeutic new implications of the agent. Potential mechanisms may include weight loss that improves lung function and improvement of glucose metabolism with reduction of systemic inflammation and improvement of endothelial dysfunction [ 21 ]. More importantly, these results need to be further evaluated in future clinical trials with pulmonary disease as the primary outcome [ 21 ].…”

FDG-PET/CT-based respiration-gated lung segmentation and quantification of lung inflammation in COPD patients

“…Glucagon-Like-Peptide 1 receptor agonists (GLP-1 RA) are used in treatment of diabetes type 2 and for the purpose of weight loss. Among other tissues, GLP-1 receptors are expressed in the lungs and exhibit anti-inflammatory properties by reducing circulating inflammatory markers thereby reducing COPD morbidity and mortality in mice and among patients, GLP-1 RA reduce respiratory diseases including COPD exacerbations [ 3 , 4 ].…”