Asthma patients may benefit from type 2 diabetes medications

Patients with type 2 diabetes who also have asthma benefit from a diabetes medicine, usually given to help the pancreas make more insulin, which also improves asthma symptoms and may reduce inflammation in the stomachs. lungs and respiratory tract.

These types of drugs -; GLP-1 receptor agonists -; are a new class of FDA-approved therapeutic agents that are generally used in addition to metformin to control blood sugar or to induce weight loss in obese patients.

Researchers at Vanderbilt University Medical Center, Brigham and Women’s Hospital, Harvard Medical School and University Hospital Zurich in Switzerland used data from the electronic health record (EHR) of patients with asthma and diabetes type 2 patients who initiated treatment with GLP-1R agonists, finding lower rates of asthma exacerbations and reduced asthma symptoms compared to those who took other type diabetes medications 2.

Their results were published in the American Journal of Respiratory and Critical Care Medicine.

We have truly shown for the first time that this class of drugs used to treat type 2 diabetes and obesity can also be of benefit to our asthma patients. “

Katherine Cahill, MD, Study Lead Author and Medical Director, Asthma Clinical Research, Division of Allergy, Lung, and Critical Care Medicine, Vanderbilt University Medical Center

“Over a six-month period, patients with type 2 diabetes who received this form of medicine to improve blood sugar control also had better control of their disease and asthma symptoms compared to those who followed. alternative therapies, ”she said.

Cahill’s study was a retrospective and observational study, so definitive prospective studies such as a clinical trial in patients with asthma, with and without comorbid type 2 diabetes, are needed to confirm that these drugs are of benefit to the patient. ‘asthma.

“For patients with type 2 diabetes and asthma, this means that some of their type 2 diabetes medications may actually help control their asthma,” Cahill said.

“For patients who have asthma but do not have type 2 diabetes, this means that there could be a new class of drugs that could be used for treatment.”

In preclinical models completed at VUMC, GLP-1R agonists have been shown to reduce allergic airway inflammation and viral airway inflammation.

To translate these findings into human disease, Cahill and colleagues took advantage of the widespread use of GLP-1R agonists for the treatment of type 2 diabetes and the clinical information available in the EHR data.

VUMC colleagues Shinji Toki, PhD, Melissa Bloodworth, MD, PhD, Stokes Peebles, MD, and Kevin Niswender, MD, PhD, had previously shown in preclinical models of asthma that this class of drugs reduces lung inflammation as well that the way the lung responds to certain challenges like allergies and viruses.

Other early preclinical data also suggests that it is possible that this therapy may have airway benefits for other airway diseases.

“In our study, we found that asthma patients received benefits from this drug because they had improved asthma control, hence fewer asthma symptoms and fewer flare-ups, or what we call them. exacerbations, of their asthma, ”Cahill said.

“Our study showed that patients reported better respiratory symptoms and fewer reports of breathlessness and coughing.”

A member of the class of drugs that induce early satiety, leading to weight loss, is already approved for the treatment of obesity. Future studies will determine whether the drug could improve outcomes for patients with both asthma and obesity.

Colleagues at Cahill and VUMC have received funding from the National Institutes of Health (NIH) to launch a randomized, controlled clinical trial of GLP-1R agonists in asthma within the next year.

“Our next step is to take this drug and study it in patients with asthma. At Vanderbilt, we’re actually going to look at obese and asthma patients and assess whether or not the drug improves their asthma. Cahill said.

Source:

Journal reference:

Foer, D., et al. (2021) Asthma exacerbations in patients with type 2 diabetes and asthma on glucagon-like peptide-1 receptor agonists. American Journal of Respiratory and Critical Care Medicine. doi.org/10.1164/rccm.202004-0993OC.


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