Pulmonary outcomes of incretin-based therapies in COPD patients receiving single-inhaler triple therapy
Background Patients with COPD on triple therapy often face exacerbations and comorbidities. Emerging evidence suggests that glucagon-like peptide-1 (GLP-1) analogues may reduce the risk of exacerbation in patients with COPD and type 2 diabetes mellitus (T2DM). This study investigates the impact of G...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2025-04-01
|
| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/11/2/00803-2024.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849314180809621504 |
|---|---|
| author | Xin Ya See Nutchapon Xanthavanij Yu-Che Lee Tze Ern Ong Tsu Hsien Wang Omer Ahmed Yu-Cheng Chang Chun-Yu Peng Kuan-Yu Chi Yu Chang Ko-Yun Chang Cho-Han Chiang |
| author_facet | Xin Ya See Nutchapon Xanthavanij Yu-Che Lee Tze Ern Ong Tsu Hsien Wang Omer Ahmed Yu-Cheng Chang Chun-Yu Peng Kuan-Yu Chi Yu Chang Ko-Yun Chang Cho-Han Chiang |
| author_sort | Xin Ya See |
| collection | DOAJ |
| description | Background
Patients with COPD on triple therapy often face exacerbations and comorbidities. Emerging evidence suggests that glucagon-like peptide-1 (GLP-1) analogues may reduce the risk of exacerbation in patients with COPD and type 2 diabetes mellitus (T2DM). This study investigates the impact of GLP-1 analogues on pulmonary outcomes in patients with COPD on single-inhaler triple therapy (SITT) and T2DM.
Methods
We conducted a retrospective cohort study using the TriNetX database and analysed adult patients with COPD and T2DM who received SITT between April 2005 and July 2023. Patients were categorised into GLP-1 analogue and dipeptidyl peptidase-4 inhibitor (DPP4i) cohorts. The primary efficacy outcome was COPD exacerbation, and the secondary efficacy outcomes were pneumonia, acute respiratory distress syndrome, intubation, oxygen dependence and all-cause mortality. The secondary outcomes were serious gastrointestinal adverse events.
Results
We included 6898 patients, with 4184 receiving GLP-1 analogues and 2714 receiving DPP4i. After matching, 1751 GLP-1 analogue users were matched with 1751 DPP4i users. GLP-1 analogue users had an 18% lower risk of COPD exacerbation (hazard ratio (HR) 0.82 (95% CI 0.71–0.94)), a 28% reduced risk of pneumonia (HR 0.72 (95% CI 0.61–0.85)), a 34% reduced risk of oxygen dependence (HR 0.66 (95% CI 0.47–0.91)) and a 40% decreased risk of all-cause mortality (HR 0.60 (95% CI 0.47–0.77)). No significant serious gastrointestinal adverse events were observed.
Conclusion
GLP-1 analogues may be associated with reduced COPD exacerbations, pulmonary comorbidities and mortality in patients with COPD receiving SITT and T2DM, with no significant serious gastrointestinal safety concerns. |
| format | Article |
| id | doaj-art-1cdd485e45734e01b25a2c6b48bf969b |
| institution | Kabale University |
| issn | 2312-0541 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj-art-1cdd485e45734e01b25a2c6b48bf969b2025-08-20T03:52:32ZengEuropean Respiratory SocietyERJ Open Research2312-05412025-04-0111210.1183/23120541.00803-202400803-2024Pulmonary outcomes of incretin-based therapies in COPD patients receiving single-inhaler triple therapyXin Ya See0Nutchapon Xanthavanij1Yu-Che Lee2Tze Ern Ong3Tsu Hsien Wang4Omer Ahmed5Yu-Cheng Chang6Chun-Yu Peng7Kuan-Yu Chi8Yu Chang9Ko-Yun Chang10Cho-Han Chiang11 Department of Medicine, Unity Hospital, Rochester Regional Health, Rochester, NY, USA Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, USA Division of Pulmonary, Critical Care and Sleep Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA Department of Medicine, University Malaya Medical Centre, Selangor, Malaysia Department of Medicine, University at Buffalo-Catholic Health System, Buffalo, NY, USA Department of Medicine, Unity Hospital, Rochester Regional Health, Rochester, NY, USA Department of Medicine, Danbury Hospital, Danbury, CT, USA Department of Medicine, Danbury Hospital, Danbury, CT, USA Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA Section of Neurosurgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Division of Chest Medicine, Taichung Veterans General Hospital, Taichung, Taiwan Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, USA Background Patients with COPD on triple therapy often face exacerbations and comorbidities. Emerging evidence suggests that glucagon-like peptide-1 (GLP-1) analogues may reduce the risk of exacerbation in patients with COPD and type 2 diabetes mellitus (T2DM). This study investigates the impact of GLP-1 analogues on pulmonary outcomes in patients with COPD on single-inhaler triple therapy (SITT) and T2DM. Methods We conducted a retrospective cohort study using the TriNetX database and analysed adult patients with COPD and T2DM who received SITT between April 2005 and July 2023. Patients were categorised into GLP-1 analogue and dipeptidyl peptidase-4 inhibitor (DPP4i) cohorts. The primary efficacy outcome was COPD exacerbation, and the secondary efficacy outcomes were pneumonia, acute respiratory distress syndrome, intubation, oxygen dependence and all-cause mortality. The secondary outcomes were serious gastrointestinal adverse events. Results We included 6898 patients, with 4184 receiving GLP-1 analogues and 2714 receiving DPP4i. After matching, 1751 GLP-1 analogue users were matched with 1751 DPP4i users. GLP-1 analogue users had an 18% lower risk of COPD exacerbation (hazard ratio (HR) 0.82 (95% CI 0.71–0.94)), a 28% reduced risk of pneumonia (HR 0.72 (95% CI 0.61–0.85)), a 34% reduced risk of oxygen dependence (HR 0.66 (95% CI 0.47–0.91)) and a 40% decreased risk of all-cause mortality (HR 0.60 (95% CI 0.47–0.77)). No significant serious gastrointestinal adverse events were observed. Conclusion GLP-1 analogues may be associated with reduced COPD exacerbations, pulmonary comorbidities and mortality in patients with COPD receiving SITT and T2DM, with no significant serious gastrointestinal safety concerns.http://openres.ersjournals.com/content/11/2/00803-2024.full |
| spellingShingle | Xin Ya See Nutchapon Xanthavanij Yu-Che Lee Tze Ern Ong Tsu Hsien Wang Omer Ahmed Yu-Cheng Chang Chun-Yu Peng Kuan-Yu Chi Yu Chang Ko-Yun Chang Cho-Han Chiang Pulmonary outcomes of incretin-based therapies in COPD patients receiving single-inhaler triple therapy ERJ Open Research |
| title | Pulmonary outcomes of incretin-based therapies in COPD patients receiving single-inhaler triple therapy |
| title_full | Pulmonary outcomes of incretin-based therapies in COPD patients receiving single-inhaler triple therapy |
| title_fullStr | Pulmonary outcomes of incretin-based therapies in COPD patients receiving single-inhaler triple therapy |
| title_full_unstemmed | Pulmonary outcomes of incretin-based therapies in COPD patients receiving single-inhaler triple therapy |
| title_short | Pulmonary outcomes of incretin-based therapies in COPD patients receiving single-inhaler triple therapy |
| title_sort | pulmonary outcomes of incretin based therapies in copd patients receiving single inhaler triple therapy |
| url | http://openres.ersjournals.com/content/11/2/00803-2024.full |
| work_keys_str_mv | AT xinyasee pulmonaryoutcomesofincretinbasedtherapiesincopdpatientsreceivingsingleinhalertripletherapy AT nutchaponxanthavanij pulmonaryoutcomesofincretinbasedtherapiesincopdpatientsreceivingsingleinhalertripletherapy AT yuchelee pulmonaryoutcomesofincretinbasedtherapiesincopdpatientsreceivingsingleinhalertripletherapy AT tzeernong pulmonaryoutcomesofincretinbasedtherapiesincopdpatientsreceivingsingleinhalertripletherapy AT tsuhsienwang pulmonaryoutcomesofincretinbasedtherapiesincopdpatientsreceivingsingleinhalertripletherapy AT omerahmed pulmonaryoutcomesofincretinbasedtherapiesincopdpatientsreceivingsingleinhalertripletherapy AT yuchengchang pulmonaryoutcomesofincretinbasedtherapiesincopdpatientsreceivingsingleinhalertripletherapy AT chunyupeng pulmonaryoutcomesofincretinbasedtherapiesincopdpatientsreceivingsingleinhalertripletherapy AT kuanyuchi pulmonaryoutcomesofincretinbasedtherapiesincopdpatientsreceivingsingleinhalertripletherapy AT yuchang pulmonaryoutcomesofincretinbasedtherapiesincopdpatientsreceivingsingleinhalertripletherapy AT koyunchang pulmonaryoutcomesofincretinbasedtherapiesincopdpatientsreceivingsingleinhalertripletherapy AT chohanchiang pulmonaryoutcomesofincretinbasedtherapiesincopdpatientsreceivingsingleinhalertripletherapy |