This research examines the effect of different glucose-lowering drugs on the risk of exacerbations of chronic obstructive pulmonary disease (COPD) in patients with type 2 diabetes (T2D) and active COPD. With the assistance of three large U.S. insurance claims databases, researchers contrasted sodium-glucose cotransporter-2 inhibitors (SGLT-2is), glucagon-like peptide-1 receptor agonists (GLP-1RAs), and dipeptidyl peptidase-4 inhibitors (DPP-4is) in three 1:1 propensity score–matched cohort analyses to mimic the conditions of real-world clinical trials.
The first occurrence of a moderate or severe COPD exacerbation, defined as either an outpatient visit for COPD followed by a prescription for an oral glucocorticoid or a hospitalization for COPD, was the primary outcome measured. The findings showed that patients who received SGLT-2is and GLP-1RAs had a reduced risk of COPD exacerbations compared to patients who received DPP-4is. More specifically, SGLT-2is was associated with 2.2 fewer exacerbations per 100 person-years compared with DPP-4is, and GLP-1RAs showed 1.6 fewer exacerbations per 100 person-years compared with DPP-4is. However, no statistically significant difference was found between SGLT-2is and GLP-1RAs.
The research highlights the potential advantages of SGLT-2is and GLP-1RAs for patients with T2D and COPD because of their potential protective effects against COPD exacerbations. Despite this, it should be noted that the study is observational, and thus residual or unmeasured confounding factors cannot be ruled out entirely. The findings indicate that healthcare providers should consider these differences when prescribing glucose-lowering drugs to patients with both T2D and COPD.
Source: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2829731
