The relationship between the use of GLP-1 receptor agonists and the incidence of respiratory illness: a meta-analysis of randomized controlled trials

Meixin Yu; Ruxin Wang; Ling Pei; Xiaofang Zhang; Jinjing Wei; Yun Wen; Han Liu; Haowen Ye; Jinghao Wang; Lihong Wang

doi:10.1186/s13098-023-01118-6

The relationship between the use of GLP-1 receptor agonists and the incidence of respiratory illness: a meta-analysis of randomized controlled trials

Diabetol Metab Syndr. 2023 Jul 26;15(1):164. doi: 10.1186/s13098-023-01118-6.

Authors

Meixin Yu^#¹, Ruxin Wang^#¹, Ling Pei¹, Xiaofang Zhang², Jinjing Wei¹, Yun Wen¹, Han Liu¹, Haowen Ye¹, Jinghao Wang³, Lihong Wang^{4

5}

Affiliations

¹ Department of Endocrinology and Metabolism, The First Affiliated Hospital of Jinan University, No. 613, Huang pu Avenue West, Guangzhou, Guangdong, China.
² Clinical Experimental Center, The First Affiliated Hospital of Jinan University, No. 613, Huang pu Avenue West, Guangzhou, Guangdong, China.
³ Department of Pharmacy, The First Affiliated Hospital of Jinan University, No. 613, Huang pu Avenue West, Guangzhou, Guangdong, China. wangjinghao@jnu.edu.cn.
⁴ Department of Endocrinology and Metabolism, The First Affiliated Hospital of Jinan University, No. 613, Huang pu Avenue West, Guangzhou, Guangdong, China. nd6688@163.com.
⁵ The Guangzhou Key Laboratory of Basic and Translational Research on Chronic Diseases, The First Affiliated Hospital, Jinan University, Guangzhou, China. nd6688@163.com.

^# Contributed equally.

Abstract

Aim: We aimed to assess the association between the use of Glucagon-like peptide-1 receptor agonists and the risk of 12 respiratory diseases in patients with type 2 diabetes, obesity, or overweight.

Method: The PubMed (MEDLINE), EMBASE, Cochrane Library, and ClinicalTrials.gov databases were searched from the establishment of the database to December 24, 2022. Dichotomous outcomes were analyzed using RR and 95% CI calculated from fixed-effects models.

Results: Twenty-eight RCTs were ultimately included for analysis, involving a total of 77,485 participants. Compared to controls, patients with GLP-1RAs have a 14% lower risk of respiratory disease (RR 0.86, 95% CI 0.81-0.93 p < 0.0001), with Semaglutid (RR 0.82, 95% CI 0.68-0.97, p = 0.02), Liraglutide (RR 0.86. 95% CI 0.75-0.98, p = 0.03), Dulaglutide (RR 0.82, 95% CI 0.70-0.96, p = 0.02), Albiglutide (RR 0.93,95% CI 0.79-1.10, p = 0.40), Exenatide (RR 0.93, 95% CI 0.74-1.18, p = 0.55), Lixisenatide (RR 0.83, 95% CI 0.62-1.12, p = 0.22), and Efpeglenatide (RR 0.76, 95% CI 0.46-1.24, p = 0.27). Semaglutide, Liraglutide and Dulaglutide reduce the risk of respiratory diseases by 18%, 14% and 18%, respectively.Trial duration, control type, and indication were not associated with the impact of GLP-1 receptor agonists on overall respiratory disease. Among secondary outcomes, the risk of Pulmonary edema (RR 0.66, 95% CI 0.44-0.98, p = 0.04), and Bronchitis (RR 0.86, 95% CI 0.74-1.00, p = 0.04) was reduced.

Conclusion: In conclusion, GLP-1RAs were linked to a lower risk of overall respiratory diseases, especially Pulmonary edema and Bronchitis. In the future, physicians should pay attention to the relationship between GLP-1 RA and the risk of respiratory diseases and evaluate the efficacy of GLP-1RAs in the primary and secondary prevention of respiratory diseases. Trial registration CRD42023396138.

Keywords: Diabetes mellitus, type 2; GLP-1RA; Meta-analysis; Randomized controlled trial; Respiratory illness.