JAMA Intern Med

Some diabetes drugs may reduce risk of COPD exacerbations

February 12, 2025

Study details: This comparative effectiveness study analyzed data from three U.S. insurance claims databases from 2013 to 2023 and included patients ≥40 years with T2DM and active chronic obstructive pulmonary disease (COPD). The risk of moderate or severe COPD exacerbations was compared among patients initiating treatment with sodium-glucose cotransporter-2 inhibitors (SGLT-2is), glucagon-like peptide-1 receptor agonists (GLP-1RAs), and dipeptidyl peptidase-4 inhibitors (DPP-4is) within three propensity score-matched cohorts of pairs: SGLT-2i vs. DPP-4i (n=27,991 pairs), GLP-1RA vs. DPP-4i (n=32,107), and SGLT-2i vs. GLP-1RA (n=36,218).

Results: The risk of moderate or severe COPD exacerbations was significantly lower in patients treated with SGLT-2is compared with DPP-4is (hazard ratio, [HR], 0.81; 95% confidence interval [CI], 0.76-0.86) and in those treated with GLP-1RAs compared with DPP-4is (HR, 0.86; 95% CI, 0.81-0.91). There were minimal differences between SGLT-2is and GLP-1RAs (HR, 0.94; 95% CI, 0.89-1.00).

Clinical impact: SGLT-2is and GLP-1RAs are associated with a reduced risk of COPD exacerbations in patients with T2DM and active COPD compared with DPP-4is. The findings support consideration of these medications in managing patients with coexisting T2DM and COPD. Given the observational nature of the study, however, authors caution that residual or unmeasured confounding cannot be ruled out.

Source:

Ray A, et al. (2025, February 10). JAMA Intern Med. Glucose-Lowering Medications and Risk of Chronic Obstructive Pulmonary Disease Exacerbations in Patients With Type 2 Diabetes. https://pubmed.ncbi.nlm.nih.gov/39928303/