GLP-1s Associated With Reduced Asthma Exacerbation Risk in Nondiabetic Patients With Obesity

Treatment with glucagon-like peptide-1 (GLP-1) receptor agonists was significantly associated with a reduced risk of asthma exacerbations in nondiabetic patients with obesity, according to research presented at the 2026 American Academy of Allergy, Asthma & Immunology Annual Meeting in Philadelphia, Pennsylvania. When presenting the data, Ruchi Patel, MD, an internal medicine resident at Rutgers New Jersey Medical School in Newark, emphasized that these associations were present across all weight groups.¹

Previous Data and Their Findings

At the start of the presentation, Patel explained that preclinical models suggest that GLP-1 receptor agonists have been shown to decrease production of interleukin (IL)-6, IL-1β, and tumor necrosis factor-α, as well as reduce oxidative stress and decrease mucus hypersecretion and airway hyperresponsiveness. Additionally, bronchodilatory effects have also been observed in ex vivo human airway tissue.¹

Other research found that use of GLP-1 receptor agonists results in lower counts of asthma exacerbations in adult patients with diabetes and either overweight or obesity. Specifically, one study published in the American Journal of Respiratory and Critical Care Medicine found that GLP-1 receptor agonists had more notable effects on lowering exacerbation risk compared with other drugs, such as sodium-glucose transport 2 inhibitors, dipeptidyl peptidase-4 inhibitors, sulfonylureas, and basal insulin.² A review published in Pulmonary Therapy confirmed this and added that weight loss improves asthma-related outcomes through a variety of possible mechanisms, such as lung mechanics, changes in oxidative stress, and reduction of inflammation.³

Therefore, GLP-1 signaling of the significant numbers of receptors found in the lungs presents a novel target for the treatment of chronic airway inflammation related to asthma, with further trials needed to clarify the optimal population for benefit.^2,3 However, it is important to note that these findings were observed in diabetic patients with obesity and asthma, and did not take nondiabetic patients into account.

“Our big question was ‘do GLP-1s improve asthma control independent of diabetes?’ So, our objective was to see whether GLP-1s will reduce asthma exacerbations in nondiabetic adults [with] overweight and obes[ity], and we wanted to see how consistent this would be across body mass index (BMI) categories,” said Patel.¹

Study Design

The study utilized data from the global collaborative network in TriNetX. All enrolled nondiabetic patients had asthma and overweight (n = 710; BMI: 25.00–29.99 kg/m²), obesity (n = 1515; BMI: 30.00–40.00 kg/m²), or morbid obesity (n = 1249; BMI: ≥40.00 kg/m²) asthma. Exacerbation rates among those initiating a GLP-1 receptor agonist and matched controls without GLP-1 exposure were compared over a 3-year period. According to Patel, the GLP-1 receptor agonists included were semaglutide (Wegovy; Novo Nordisk), tirzepatide (Zepbound; Eli Lilly), and liraglutide (Saxenda; Novo Nordisk). Patients were ineligible for study enrollment if they were receiving immunotherapies.¹

The primary end point was whether GLP-1 receptor agonists reduce asthma exacerbations in nondiabetic adults who are overweight and obese, and the secondary end point was to assess consistency across all BMI categories.¹

What Did the Study Find?

Patel explained that across all weight groups exposed to GLP-1 receptor agonists, the relative risk of exacerbation compared with the non–GLP-1 exposed cohorts demonstrated lower absolute risk of asthma exacerbation. Specifically, GLP-1 initiation was associated with a reduced risk of asthma exacerbation with a risk ratio of 0.748 and a risk difference of 14.6% in the overweight group, 0.790 and 12.2% in the obese group, and 0.780 and 13.3%, respectively, in the morbidly obese group. These results were all considered statistically significant (p < .0001).¹

“[For] the overweight group, I would have expected a more modest weight loss compared with the other BMI categories, but nevertheless, our results stay pretty consistent,” explained Patel. “And again, because this is a nondiabetic population, this rules out the glycemic control effect. So, perhaps [there] are other [factors contributing to this], including the weight loss and/or airway inflammation.”¹

What Should Pharmacists Know About These Findings?

Pharmacists should be aware that GLP-1 receptor agonists may offer benefits beyond weight loss, including a potential reduction in asthma exacerbations in nondiabetic patients with overweight or obesity. These findings suggest a possible anti-inflammatory and airway-modulating role that is independent of glycemic control, which pharmacists should consider when evaluating treatment options for patients with comorbid asthma and obesity.

As medication experts, pharmacists can help identify appropriate candidates, reinforce adherence, and counsel patients on expected benefits and adverse effects, while also recognizing that this is an emerging area of research not yet reflected in formal asthma treatment guidelines. Additionally, pharmacists should collaborate with prescribers to monitor outcomes, consider the impact of weight loss on respiratory function, and stay informed as further clinical data clarify which patient populations may experience the greatest benefits.

“[As far as limitations,] this is a retrospective observational study. [We] cannot measure individual weight loss directly, and there is some variability in the [International Statistical Classification of Diseases, Tenth Revision] coding and also some room for residual confounding,” Patel concluded. “I think that [these findings] set up a strong rationale for future prospective trials. GLP-1s are an emerging strategy for these obesity-associated patients [with asthma] for which there are limited phenotype-specific therapies.”¹

REFERENCES

1. Patel R. Asthma control in the real world: influences and associations – association between glucagon-like peptide-1 receptor agonists and asthma exacerbations in non-diabetic patients with obesity: cohort study. Presented at: American Academy of Allergy, Asthma & Immunology Annual Meeting; Philadelphia, PA; February 27-March 2, 2026. Abstract 2602.

2. Foer D, Beeler PE, Cui J, Karlson EW, Bates DW, Cahill KN. Asthma exacerbations in patients with type 2 diabetes and asthma on glucagon-like peptide-1 receptor agonists. Am J Respir Crit Care Med. 2021;203(7):831-840. doi:10.1164/rccm.202004-0993OC

3. Kaplan AG, Kim JW. Asthma exacerbations and glucagon-like peptide-1 receptor agonists: a review of the current evidence. Pulm Ther. 2022;8(4):343-358. doi:10.1007/s41030-022-00203-x