Allergy & & Immunology > Asthma– Addition of GLP-1 drugs caused an even higher decrease
by Sophie Putka, Enterprise & & Investigative Writer, MedPage Today November 19, 2024
Treatment with metformin was related to a decrease in asthma attacks amongst clients with asthma and type 2 diabetes, with extra decreases observed with making use of GLP-1 receptor agonists, according to a self-controlled case series and population-based accomplice research study.
Amongst over 12,000 clients, usage of metformin was connected with less asthma attacks in both the self-controlled case series analysis (occurrence rate ratio [IRR] 0.68, 95% CI 0.62-0.75) and an analysis of a brand-new user accomplice with inverted possibility of treatment weighting (IPTW; HR 0.76, 95% CI 0.67-0.85), reported Chloe I. Bloom, MSc, PhD, of Imperial College London, and coworkers in JAMA Internal Medicine.
Of the other antidiabetic medications assessed, just GLP-1 receptor agonists appeared to have an additive association (IRR 0.60, 95% CI 0.49-0.73).
“Metformin had a remarkably strong impact, minimizing asthma attacks by about 30%. It didn’t appear to be impacted by metabolic aspects [body mass index (BMI), glycemic control] or asthma phenotype [type 2 inflammation, asthma severity],” Bloom informed MedPage Today
“We likewise saw a substantial result from including GLP-1s, with an extra 40% decrease in asthma attacks. These 2 diabetes medications together for that reason seem more efficient than asthma biologics,” she included.
Numerous asthma clients likewise have type 2 diabetes, and are at greater threat for asthma attacks. Previous research studies have actually recommended that metformin and GLP-1 receptor agonists might decrease these attacks.
“Many asthma clients have actually comorbid metabolic conditions; we require to be considering this in our regular asthma care,” Bloom stated. “The landscape for dealing with metabolic conditions is quickly altering, [and] much of these medications might deal with both asthma and their metabolic condition. Metformin is inexpensive, quickly offered, and an oral medication; these aspects make it a really appealing drug to be repurposed for asthma.”
In an accompanying editorial, Katherine N. Cahill, MD, of Vanderbilt University Medical Center in Nashville, Tennessee, and Dinah Foer, MD, of Brigham and Women’s Hospital in Boston, composed that the research study findings recommend that asthma’s reaction to metformin in those with diabetes was independent of asthma inflammatory phenotypes, which forecast scientific action to existing treatments like biologics.
“In this regard, the [current] analyses … surpass supporting the preferential usage of these medications in clients with comorbid type 2 diabetes and asthma,” Cahill and Foer composed, “raising the concern if metformin and GLP-1RAs [receptor agonists] ought to be thought about for asthma treatment without type 2 diabetes.”
They kept in mind that there have actually been no comparable stage III randomized trials of type 2 diabetes medications in an associate with diabetes that examined persistent breathing illness as a main or secondary result. “This oversight might show our siloed biomedical business, contending pharmaceutical market interests, and the strong headwinds investigator-initiated trials deal with” in getting their trials off the ground,