ECO 2026
GLP-1s tied to fewer asthma issues, less inhaler use
Clinical Takeaway: For patients with asthma plus overweight, obesity, and/or type 2 diabetes who are candidates for GLP-1 therapy, respiratory outcomes may be a meaningful secondary benefit.
Obesity and metabolic dysfunction worsen asthma severity and exacerbation risk, and the airway inflammation driven by excess adipose tissue appears mechanistically distinct from classic eosinophilic asthma. This study tested whether GLP-1 receptor agonists, increasingly prescribed for weight and glycemic control, also track with better asthma control in real-world practice.
Asthma exacerbation rates fell 26% in the year following GLP-1 initiation compared with the year before, across 27,523 adults with asthma and either overweight, obesity or type 2 diabetes. Reliever inhaler use dropped 14%, daily inhaled corticosteroid exposure fell 23%, and pneumonia events declined 10%. The reduction in inhaled corticosteroid use alongside fewer symptoms suggests improved underlying control rather than treatment de-escalation alone.
Effects were similar across indications, with a 22% exacerbation reduction in patients treated for overweight or obesity and a 26% reduction in those treated for type 2 diabetes. Men saw slightly larger reductions than women (28% vs. 23%). Patients with comorbid allergic rhinitis showed a similar magnitude of benefit (23%) to those without (28%), suggesting the effect is not confined to one inflammatory phenotype.
Researchers used linked Danish health registries to identify adults with prior asthma diagnoses or recent inhaler use who began a GLP-1 receptor agonist. Each patient served as their own control, with outcomes compared in the 12 months before and after the index prescription. Liraglutide and semaglutide accounted for nearly all prescriptions. Patients with COPD or those on asthma biologics were excluded. The findings were presented as a conference abstract and have not yet undergone peer review.
"There's a high chance that the weight loss is a major contributor to these results. A common symptom in both asthma and obesity is shortness of breath, and the presence of excess fatty tissue creates a pro-inflammatory state in the body in general. There's also evidence from other studies suggesting that the inflammation caused by excess adipose tissue is distinct from the 'classic' asthma inflammation which often is driven by allergies or cells called eosinophils," said Kjell Erik Julius Håkansson, MD, of Copenhagen University Hospital.
Source: Høj S. ECO 2026. May 14, 2026. GLP-1 receptor agonists and asthma outcomes in a nationwide self-controlled cohort