- 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
Now, a new study published in
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.
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.
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.”
