Introduction & objective: Recent studies suggest a possible therapeutic role of glucose-lowering drugs for chronic obstructive pulmonary disease (COPD). We compared sodium-glucose cotransporter-2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP1-RA), and dipeptidyl peptidase 4 inhibitors (DPP4i) regarding the risk of COPD exacerbations.
Methods: Using data from a US commercial claims database (2013-2023), we identified 7,472 pairs of 1:1 propensity score (PS) matched adults aged >=40 years with type 2 diabetes (T2D) initiating SGLT2i or DPP4i, 7,600 pairs initiating GLP1-RA or DPP4i, and 10,187 pairs initiating SGLT2i or GLP1-RA. We estimated HRs and 95% CIs for the risk of a COPD exacerbation, defined as an inpatient COPD diagnosis (severe exacerbation) or an outpatient COPD diagnosis and a filled prescription of oral prednisone (moderate exacerbation), adjusting for 91 covariates.
Results: The risk of moderate or severe COPD exacerbation was lower in the SGLT2i (HR, 0.79; 95% CI, 0.71-0.88) and the GLP1-RA (HR, 0.79; 95% CI, 0.71-0.88) groups compared with DPP4i, and was similar between SGLT2i and GLP1-RA (HR, 0.93; 95% CI, 0.83-1.03), over a median follow-up of 4.3 months on treatment (Table). Results were consistent in subgroup analyses based on asthma history.
Conclusion: SGLT2i and GLP1-RA were associated with reduced risk of moderate or severe COPD exacerbations, compared to DPP4i in adults with T2D.
A. Ray: None. J.M. Paik: None. W.B. Feldman: None. S. Kattinakere Sreedhara: None. D.J. Wexler: Other Relationship; Novo Nordisk. E. Patorno: Research Support; Boehringer-Ingelheim, Food and Drug Administration (FDA), National Institutes of Health, Patient-Centered Outcomes Research Institute.
