Do asthma patients prescribed a GLP1 have improved asthma and weight loss outcomes?

Glucagon-Like Peptide-1?s (GLP1) are used for diabetes and weight management in the UK. There is evidence that high blood sugar levels in people with type 2 diabetes impair lung function with increases in average blood sugar levels from 4 mmol/L to 12 mmol/L, resulting in a 20% drop in lung function1.

This analysis aimed to determine if there were improved asthma outcomes in patients prescribed GLP1. Data from the Optimum Patient Care Research Database for the cases and controls were extracted. Cases were those with treated asthma, a GLP1 and a BMI ?30 (n=10,111). Control group (5:1) patients were matched on age, gender, prior exacerbations, and baseline SABA prescribing (50,555). Asthma outcomes were measured using two composite indexes, Risk Domain Asthma Control (RDAC) and Overall Asthma Control (OAC).

RDAC ?uncontrolled? had either an asthma-related hospital attendance, an acute OCS and/or an antibiotic with a respiratory review. OAC was controlled if they were classified as ?controlled? by RDAC and used <3 SABA inhalers. Logistic regressions were undertaken to compare asthma outcomes.

GLP1 patients were found to have better outcomes for both RDAC and OAC measures. Controlling for baseline measures the OR were 2.1 (1.9-2.4) and 2.1 (1.8-2.5) respectively. Weight was found to decrease for both groups, though greater in the GLP1 population. GLP1 patients had lower, non-significant, number of exacerbations 0.52 (0.50-0.54) vs 0.54 (0.53-0.55).

Obese asthmatics are a group with higher morbidity, this study shows use of GLP1 provides substantially improvements in asthma control. Whether this is related to weight loss, diabetes control or an anti-inflammatory effect requires further study.