Type 2 diabetes patients who also have asthma benefit from diabetes medication, which is usually given to help the pancreas make more insulin. This also improves asthma symptoms and can reduce pneumonia and airway inflammation.
These types of drugs -; GLP-1 receptor agonists -; are a newer class of FDA-cleared therapeutics that are commonly used in addition to metformin to control blood sugar or induce weight loss in obese patients.
Researchers at Vanderbilt University Medical Center, Brigham and Women’s Hospital, Harvard Medical School, and University Hospital Zurich in Switzerland used electronic health records (EHR) from patients with asthma and type 2 diabetes who were treated with GLP-1R agonists had started and found lower rates of asthma exacerbations and reduced asthma symptoms compared to those who started other type 2 diabetes medications.
Their results were published in the American Journal of Respiratory and Critical Care Medicine.
We’ve really shown, for the first time, that this class of drugs used to treat type 2 diabetes and obesity can also benefit our asthma patients. “
Katherine Cahill, MD, Study Director and Medical Director, Clinical Asthma Research, Department of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center
“Over a six-month period, type 2 diabetes patients who were given this form of blood sugar control medication also had better control of their asthma diseases and symptoms than those who took alternative therapies,” she said.
Cahill’s study was a retrospective observational study. Therefore, definitive prospective studies, such as a clinical study in patients with asthma with and without comorbid type 2 diabetes, are needed to confirm that these drugs provide benefits for asthma.
“For patients with type 2 diabetes and asthma, this means that some of their type 2 diabetes drugs can actually help control asthma,” said Cahill.
“For patients with asthma but possibly without type 2 diabetes, this means that there could be a new class of drugs that could be used to treat it.”
In preclinical models performed at VUMC, GLP-1R agonists have been shown to reduce allergic airway inflammation and virally induced airway inflammation.
To translate these results into human disease, Cahill and colleagues took advantage of the widespread use of GLP-1R agonists to treat type 2 diabetes and the clinical information available in EHR data.
VUMC colleagues Shinji Toki, Melissa Bloodworth, Stokes Peebles and Kevin Niswender had previously shown in preclinical asthma models that this class of drugs reduced inflammation in the lungs and how the lungs respond to certain challenges such as allergies and viruses.
Other early preclinical data also suggest that this therapy could potentially have benefits for other respiratory diseases in the airways.
“In our study, we found that patients with asthma benefited from this drug because they had better asthma control, fewer asthma symptoms, and fewer acute flares or so-called exacerbations of their asthma,” said Cahill.
“Our study showed that patients reported better breathing symptoms and fewer reports of shortness of breath and coughing.”
One member of the drug class that induces early satiety and leads to weight loss is already approved for the treatment of obesity. Future studies will investigate whether the drug can improve outcomes for patients with asthma and obesity.
Cahill and VUMC colleagues have received funding from the National Institutes of Health (NIH) to start a randomized, controlled clinical trial of GLP-1R agonists in asthma next year.
“Our next step is to take this drug and study it in patients with asthma. Here at Vanderbilt, we’re actually going to study patients who are overweight and have asthma and assess whether or not the drug actually improves their asthma.” Said Cahill.
Vanderbilt University Medical Center
Foer, D. et al. (2021) Asthma exacerbations in patients with type 2 diabetes and asthma with glucagon-like peptide 1 receptor agonists. American Journal of Respiratory and Critical Care Medicine. doi.org/10.1164/rccm.202004-0993OC.