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Background <p>Chronic obstructive pulmonary disease (COPD) is a progressive lung condition worsened by systemic inflammation and metabolic disturbances. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), used for type 2 diabetes mellitus (T2DM), have shown anti-inflammatory benefits.</p> Objective <p>This study examines the association between GLP-1 RAs’ use and the risk of severe COPD exacerbations.</p> Methods <p>This retrospective cohort study included patients with COPD and T2DM who initiated GLP-1 RAs between 2020 and 2022. 624 patients (312 pairs) were categorized into GLP-1 RAs users and non-users after propensity score matching (PSM). The median follow-up time was 14&#xa0;months for GLP-1 RAs users and 13&#xa0;months for non-users. Multivariate Cox regression analysis was performed to evaluate the relationship between GLP-1 RAs use and the risk of severe exacerbations, adjusting for potential confounders.</p> Results <p>A total of 175 (28.0%) patients incurred ≥ 1 severe exacerbation. The incidence of exacerbations was significantly lower in GLP-1 RAs users compared to non-users (17.3% vs. 38.8%, <i>p</i> &lt; 0.01). Time-to-event analysis revealed that the risk of subsequent severe exacerbation of COPD was significantly lower in GLP-1 RAs users (HR = 0.42, 95% CI: 0.31–0.57; <i>p</i> &lt; 0.01). Multivariate Cox regression analysis revealed that the use of GLP-1 RAs was independently linked to a decreased risk of severe exacerbations (HR = 0.49, 95% CI: 0.34–0.69, <i>p</i> &lt; 0.01). Subgroup analyses revealed that patients with more advanced COPD benefited more from GLP-1 RAs use.</p> Conclusion <p>The use of GLP-1 RAs is linked to a decreased risk of severe exacerbations in patients with COPD and T2DM.</p>

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Use of glucagon-like peptide-1 receptor agonists reduces the risk of severe exacerbation in Chinese patients with chronic obstructive pulmonary disease and type 2 diabetes

  • 期刊论文

  • 发表日期：

    2026年5月1日

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  • Fang Wang,
  • Dan Yu,
  • Guofeng Bai

摘要

Background

Chronic obstructive pulmonary disease (COPD) is a progressive lung condition worsened by systemic inflammation and metabolic disturbances. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), used for type 2 diabetes mellitus (T2DM), have shown anti-inflammatory benefits.

Objective

This study examines the association between GLP-1 RAs’ use and the risk of severe COPD exacerbations.

Methods

This retrospective cohort study included patients with COPD and T2DM who initiated GLP-1 RAs between 2020 and 2022. 624 patients (312 pairs) were categorized into GLP-1 RAs users and non-users after propensity score matching (PSM). The median follow-up time was 14 months for GLP-1 RAs users and 13 months for non-users. Multivariate Cox regression analysis was performed to evaluate the relationship between GLP-1 RAs use and the risk of severe exacerbations, adjusting for potential confounders.

Results

A total of 175 (28.0%) patients incurred ≥ 1 severe exacerbation. The incidence of exacerbations was significantly lower in GLP-1 RAs users compared to non-users (17.3% vs. 38.8%, p < 0.01). Time-to-event analysis revealed that the risk of subsequent severe exacerbation of COPD was significantly lower in GLP-1 RAs users (HR = 0.42, 95% CI: 0.31–0.57; p < 0.01). Multivariate Cox regression analysis revealed that the use of GLP-1 RAs was independently linked to a decreased risk of severe exacerbations (HR = 0.49, 95% CI: 0.34–0.69, p < 0.01). Subgroup analyses revealed that patients with more advanced COPD benefited more from GLP-1 RAs use.

Conclusion

The use of GLP-1 RAs is linked to a decreased risk of severe exacerbations in patients with COPD and T2DM.