Patients with diabetes commonly have additional chronic diseases such as asthma or COPD. Because several diabetes medications with different mechanism of action are approved, it is important to understand which diabetes medication fits specific patients’ needs. For example some glucose-lowering drugs have shown beneficial effects on the heart, while others may cause weight gain and thus, may be harmful for patients with obesity. Unfortunately, patients with comorbidities are frequently excluded from clinical trials and therefore, the whole spectrum of effects beyond the direct effect on diabetes symptoms, either harmful or beneficial, of newly approved medications are unknown in various patient groups.
Animal studies have shown promising results of glucagon-like peptide-1 receptor agonists, or GLP-1RA, a new class of glucose lowering agents, on improving impaired lung function. In a study published in the journal Diabetes Care, researchers from the UF College of Pharmacy sought to evaluate the potential benefits of using GLP-1RA drugs for diabetes control among patients who have also asthma or COPD. They observed that the patients who initiated GLP-1RA half the risk for hospitalizations for COPD or asthma exacerbations than a similar group of patients who started alternative diabetes medications. They noted similar positive effects when examining a broader set of outcomes including emergency department visits for asthma or COPD or the need to use oral corticosteroids, drugs used to control severe asthma and COPD exacerbations. UF College of Pharmacy researchers applied several analyses to examine the results’ robustness and all findings were consistent.
In conclusion, considering both plausible mechanistic pathways proposed from bench science research, and the real-world evidence, GLP-1RA offer an added benefit when deciding on a treatment strategy for diabetic patients with asthma or COPD.
This study was led by Almut Winterstein, R.Ph., Ph.D., FISPE, a professor, the Robert and Barbara Crisafi Chair in Pharmaceutical Outcomes and Policy in the College of Pharmacy and director of the Center for Drug Evaluation and Safety at UF, and Yasser Albogami, Ph.D., M.P.H., a former graduate student in the department of pharmaceutical outcomes and policy.