Glucagon-like peptide-1 receptor agonists may benefit cardiopulmonary outcomes in patients with COPD

🥉 Top 5% JournalOct 1, 2024Thorax

Glucagon-like peptide-1 receptor agonists may improve heart and lung health in people with COPD

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Abstract

GLP-1 receptor agonist users had a 46% lower risk of mortality compared to non-users.

GLP-1 receptor agonists are associated with a lower risk of cardiovascular events (adjusted HR 0.73).
Users of GLP-1 receptor agonists experienced a reduced need for non-invasive positive pressure ventilation (adjusted HR 0.66).
Invasive mechanical ventilation risk was also lower in GLP-1 receptor agonist users (adjusted HR 0.64).
The risk of bacterial pneumonia was decreased among users of GLP-1 receptor agonists (adjusted HR 0.76).
Subgroup analyses indicate consistent lower risks of adverse cardiopulmonary outcomes with GLP-1 receptor agonist use compared to non-use.

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BACKGROUND: Clinical studies have shown that glucagon-like peptide-1 receptor agonists (GLP-1 RA) can have beneficial effects on cardiopulmonary function. We conducted this longitudinal cohort study to compare the risk of cardiopulmonary outcomes and mortality between GLP-1 RA use and no use in patients with type 2 diabetes (T2D) and chronic obstructive pulmonary disease (COPD).

METHODS: The study identified 8060 matched GLP-1 RA users and non-users from Taiwan's National Health Insurance Research Database from 1 January 2008 to 31 December 2019. Cox proportional hazards models were used to determine the risk of cardiopulmonary outcomes between GLP-1 RA users and non-users.

RESULTS: The mean follow-up time was 2.51 and 2.46 years for GLP-1 RA users and non-users, respectively. In the matched cohorts, GLP-1 RA users had a significantly lower risk of mortality (adjusted HR (aHR) 0.46, 95% CI 0.38 to 0.56), cardiovascular events (aHR 0.73, 95% CI 0.65 to 0.82), non-invasive positive pressure ventilation (aHR 0.66, 95% CI 0.47 to 0.93), invasive mechanical ventilation (aHR 0.64, 95% CI 0.51 to 0.8) and bacterial pneumonia (aHR 0.76, 95% CI 0.65 to 0.88) than GLP-1 RA non-users. The subsequent analyses for various subgroup and medication duration also showed that GLP-1 RA was associated with a significantly lower risk of mortality, cardiovascular events, ventilation support and bacterial pneumonia than non-GLP-1 RA.

CONCLUSION: This nationwide cohort study showed that GLP-1 RA had a lower risk of cardiopulmonary outcomes and all-cause mortality than non-GLP-1 RA in patients with T2D and COPD. GLP-1 RA may help manage diabetes in people with COPD.

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