Data presented at APSR 2024 demonstrate the ability of glucagon-like peptide 1 receptor agonists (GLP1-RAs) to benefit obese individuals with asthma.

“Obesity is known to be a risk factor for asthma and to be associated with poor asthma control … [Our data suggest that] prescribed GLP1-RA for weight loss may have widespread benefits on comorbidities relating to obesity, including asthma,” said the researchers.

To evaluate the effect of GLP1-RAs on asthma control, the researchers extracted data from the UK Optimum Patient Care Research Database. Cases comprised participants aged >18 years who had active asthma, a BMI of >30 kg/m², and were on GLP1-RA treatment (n=10,111; mean age at index date 55.6 years, 65 percent women). Over 40 percent of cases had a BMI of ≥40 kg/m², 46 percent were nonsmokers, and a majority (39 percent) fell under the Global Initiative for Asthma (GINA) Step 4 category.

The controls were matched 5:1 based on age, sex, BMI >30 kg/m², time at which they contributed data to the database, exacerbation, and baseline use of a short-acting beta agonist (SABA; n=50,555; mean age at index date 55.4 years, 65 percent women). About 60 percent had a BMI of ≥30?34.9 kg/m², half were nonsmokers, and most (41 percent) were also classified as GINA Step 4. [APSR 2024, abstract AP05-021]

Asthma control outcomes were determined using the Risk Domain Asthma Control (RDAC), which defined control as no recorded exacerbations, unplanned hospital attendances, and antibiotics for lower respiratory illnesses in the previous 12 months. Overall Asthma Control (OAC) defined control as a positive RDAC score and <3 SABA prescriptions.

After adjusting for BMI and oral corticosteroid use, asthma control was better among those who were receiving GLP1-RAs, as reflected by the RDAC and OAC measures (adjusted odds ratio [OR], 2.1 for both). “An OR >1 indicates better outcomes in GLP1-RA patients vs controls,” the researchers explained.

Sixty-one percent of cases lost weight, as opposed to only a quarter of control participants. The amount of weight lost was also greater in the former vs the latter group (mean 3.5 vs 0.9 kg).

More evidence needed

“[Our findings show that] GLP1-RAs are associated with increased weight loss and improved asthma control,” said the researchers. “Quantifying the [observed] associations is useful when considering the health economic choices around using these drugs.”

“Whether [the asthma control] is related to weight loss, diabetes control, or an anti-inflammatory effect requires further study,” they added.

The investigators also called for further trials to ascertain outcomes in individuals with specific asthma phenotypes, including low T2 severe asthma.

Supports wider GLP1-RA benefit

The researchers noted that despite the potential bias in follow-up weight data due to nonattendance, this real-world analysis supports the extended benefits of GLP1-RAs.

The results align with the findings of a recent study that evaluated the role of GLP-1 and glucose-dependent insulinotropic polypeptide/GLP1-RAs in the treatment of respiratory disorders. The researchers of this study noted that the multidimensional beneficial properties of these agents render them viable candidates for the treatment of various respiratory disorders on top of well-established lung-directed therapies. [Medicina 2024;60:2030]