GLP-1 Receptor Agonists Are Associated with Reduced Asthma Exacerbations Independently of Type 2 Inflammation Status: A Nationwide Self- Controlled Study
Abstract
Background: GLP-1 receptor agonists (GLP-1 RAs) reduce airway inflammation in preclinical models, but their real-world effectiveness across asthma phenotypes is unknown. We evaluated the impact of GLP-1 RAs on asthma exacerbations, stratified by type 2 (T2) inflammatory biomarkers. Methods: This nationwide self-controlled cohort study linked the Danish Asthma Registry with health registers. Patients with ≥12 months of data before/after first GLP-1 RA dispensing were included; COPD and asthma biologics users were excluded. Outcomes included exacerbations (inpatient contacts/systemic corticosteroids ≥7 days apart), pneumonia, SABA, and ICS use. Results: A total of 21,792 patients were included (mean age 51±14 years, 71% female). GLP-1 RA treatment significantly reduced asthma exacerbations and pneumonia events across virtually all T2 strata. For exacerbations, the reduction was more pronounced in patients with blood eosinophil count (BEC) ≥ 300 cells/µL vs. <300 cells/µL (IRR 0.61 [95% CI 0.55-0.67] vs. 0.70 [0.65-0.77]; pheterogeneity<0.05). Similar reductions were seen regardless of specific and total IgE strata (IRRs ~0.62). For FeNO < 25 ppb, exacerbations decreased (IRR 0.47 [0.31-0.71]), whereas the ≥ 25 ppb estimate lacked power (IRR 0.33 [0.06-1.34]). Reductions in pneumonia events were broadly consistent across BEC and IgE strata, ranging from 17% to 22%. Stratification by FeNO showed greater variation with IRRs of 0.50 [0.24-0.98] among patients with FeNO ≥ 25 ppb and IRR 0.67 [0.51-0.88] among those with FeNO < 25 ppb. Furthermore, GLP-1 RAs treatment was associated with consistent reductions in both SABA and ICS use across all T2 strata. Conclusion: GLP-1 RA use is associated with reduced risk of exacerbations, pneumonia and asthma medication use, regardless of T2 strata.
Plain language summary
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Authors
Publication
- Congress
- European Respiratory Society Congress 2026
- Year
- 2026
- Status
- Abstract published