In a real-world cohort study from the U.K., patients had fewer COPD exacerbations when diabetes was treated with GLP-1 agonists or SGLT-2 inhibitors than with sulfonylureas. The other newer class of antidiabetic drugs, DPP-4 inhibitors, did not clearly show this effect. “Further research, including confirmatory randomised controlled trials, will be needed to investigate the potential of GLP-1 receptor agonists and SGLT-2 inhibitors as a therapeutic option in patients with type 2 diabetes and chronic obstructive pulmonary disease,” the authors conclude.
Analysis of data from the U.K. Clinical Practice Research Datalink and 2 other databases showed these results for patients with type 2 diabetes and COPD who began treatment with the study drugs in 2013–2019: “Compared with sulfonylureas, GLP-1 receptor agonists were associated with a 30% decreased risk of severe exacerbation (3.5 v 5.0 events per 100 person years; hazard ratio 0.70, 95% confidence interval 0.49 to 0.99) and moderate exacerbation (0.63, 0.43 to 0.94). DPP-4 inhibitors were associated with a modestly decreased incidence of severe exacerbation (4.6 v. 5.1 events per 100 person years; hazard ratio 0.91, 0.82 to 1.02) and moderate exacerbation (0.93, 0.82 to 1.07), with confidence intervals including the null value. Finally, SGLT-2 inhibitors were associated with a 38% decreased risk of severe exacerbation (2.4 v 3.9 events per 100 person years; hazard ratio 0.62, 0.48 to 0.81) but not moderate exacerbation (1.02, 0.83 to 1.27).”