A Potential New Treatment Option for Asthma in the Setting of Obesity or Insulin Resistance?

In this issue of the Journal, Foer and colleagues (pp. 831-840) tackle this need by evaluating the association between glucagon-like peptide-1 receptor agonists (GLPI-RAs) and asthma outcomes (9). Using data from 4,373 patients with type 2 diabetes (T2D) and asthma, they compared asthma exacerbation rates between patients starting GLPI-RAs and those initiating other medications as part of T2D treatment escalation. After adjusting for propensity scores and other covariates, they report that patients starting GLP1 -RA therapy have lower asthma exacerbation rates than those initiating sulfonylureas, insulin, SGLT2 inhibitors, or DPP4 inhibitors over a 6-month period. The study has several important strengths, including the use of detailed clinical data extracted from the electronic record database of a large academic healthcare organization, which allowed the authors to adjust for important covariates at different time points. The large database allowed for the exclusion of numerous comorbidities and conditions that may confound or mimic the diagnosis of asthma, and the authors also took care in adjusting for a propensity score calculated based on the probability of initiating GLP1-RA versus other T2D medications.