Asthma Exacerbations and Glucagon-Like Peptide-1 Receptor Agonists: a Review of the Current Evidence

Pulm Ther. 2022 Dec;8(4):343-358. doi: 10.1007/s41030-022-00203-x. Epub 2022 Nov 22.

Abstract

Asthma is a chronic inflammatory disease involving multiple mediators and cytokines. While our current treatments have shown significant therapeutic benefits, there still appear to be some patients who, despite aggressive therapy, good adherence, and inhaler technique, continue to have exacerbations. Exacerbations lead to loss of lung function, exposure to systemic corticosteroids, effects on quality of life, and even mortality. There is a large number of glucagon-like peptide-1 (GLP-1) receptors in the lung even compared with other organs, and studies have shown evidence of reduced exacerbations in asthmatics treated with GLP-1 receptor agonists (GLP-1 RA). While weight loss may affect lung mechanics, evidence of inflammatory changes has been revealed that could explain this relationship. This article will review the data behind these conjectures and outline potential clinical utility and the need for future studies to truly understand the role of GLP-1 receptors in the lung.

Keywords: Asthma; Inflammation; Obesity; Phenotype; Weight loss.

Plain language summary

Obesity is a common issue and a comorbidity that negatively impacts asthma outcomes. Weight loss can improve asthma outcomes, and evidence shows that a particular type of therapy currently indicated for diabetes that assists in weight loss and targets receptors that are abundant in the lungs will outperform other therapies. GLP-1-receptor agonists may particularly help overweight patients who have asthma to control the disease as best as possible and prevent exacerbations. Video Abstract.

Publication types

  • Review