CHEST 2025: Exploring the Link Between GLP-1 Receptor Agonists, Type 2 Diabetes, and Asthma Risk

In an interview with Pharmacy Times®, Umme Kulsum, MBBS, discussed her research examining the link between glucagon-like peptide 1 (GLP-1) receptor agonists and asthma risk.

During her session at CHEST 2025, held October 19-22 in Chicago, Illinois, Kulsum shared that the analysis found that semaglutide (Ozempic, Wegovy; Novo Nordisk) may decrease asthma risk, while tirzepatide (Mounjaro, Zepbound; Eli Lilly) and albiglutide (Tanzeum; GSK) could increase it. She emphasized the need for clinicians to consider both metabolic and respiratory histories when selecting medications and called for more randomized controlled trials to clarify the respiratory effects of different GLP-1 agents.

Pharmacy Times: Can you introduce yourself?

Umme Kulsum, MBBS: My name is Umme Kulsum. I am an international medical graduate. I graduated from medical college in Bangladesh, and I am also an internal medicine residency applicant this year.

Pharmacy Times: What prompted the investigation into the relationship between GLP-1 receptor agonists and asthma risk?

Kulsum: GLP-1 receptor agonists are mainly used for type 2 diabetes mellitus, but we found that they have other effects, such as immunomodulatory and respiratory pathway effects. Many patients have both conditions—type 2 diabetes and asthma—so this prompted us to investigate whether there is any association between asthma and GLP-1 receptor agonists. That was the reason for starting this study.

Pharmacy Times: How does this Bayesian network meta-analysis compare the different GLP-1 agents studied?

Kulsum: The Bayesian network meta-analysis shows that different GLP-1 receptor agonists, such as semaglutide, which is mostly used in clinical settings now, were associated with decreased asthma risk. However, other GLP-1 receptor agonists showed no effect, while some, like tirzepatide and albiglutide, were associated with increased asthma risk. Using Bayesian interpretation with the surface under the cumulative ranking curve (SUCRA), we found this information promising because clinicians prescribing agents such as tirzepatide in patients with asthma should be aware that it may increase asthma risk.

Pharmacy Times: What were the key findings regarding GLP-1 use and asthma incidence?

Kulsum: We reviewed numerous randomized controlled trials after searching PubMed and Scopus and found data showing that tirzepatide and albiglutide are associated with increased asthma risk. Meanwhile, semaglutide, which is most commonly used, was associated with decreased asthma risk. It was initially thought that all GLP-1 agonists might decrease asthma risk, but our findings show that some actually increase it. For patients with both asthma and type 2 diabetes, drugs should be selected carefully based on individual patient criteria.

Pharmacy Times: How might these results influence clinical decision-making for patients with metabolic disease and respiratory comorbidities?

Kulsum: These findings highlight the importance of obtaining a complete medical history for patients with type 2 diabetes. Endocrinologists should evaluate the respiratory history of these patients, and similarly, pulmonologists should assess endocrine history in patients with asthma or other respiratory conditions. If a patient is not responding well to corticosteroids or asthma medications, it may be due to a medication interaction, such as GLP-1 use for diabetes. Clinicians should be aware of this when selecting medications for patients with both type 2 diabetes and asthma or other respiratory conditions.

Pharmacy Times: What further research is needed to clarify the respiratory effects of GLP-1 therapies?

Kulsum: Our study had limited power because there were not enough randomized controlled trials. More studies are needed to explore the different effects of GLP-1 agents on the respiratory pathway. Further research will help confirm which GLP-1 agents may decrease asthma risk, potentially offering dual benefits for both diabetes and asthma, while identifying those that may increase risk so they can be used with caution.