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Association of Novel Antihyperglycemic Drugs Versus Metformin With a Decrease in Asthma Exacerbations.

Yuya Kimura1, Taisuke Jo2, Norihiko Inoue3

  • 1Department of Clinical Epidemiology and Health Economics, School of Public Health, the University of Tokyo, Tokyo, Japan; Clinical Research Center, National Hospital Organization Tokyo Hospital, Tokyo, Japan.

The Journal of Allergy and Clinical Immunology. in Practice
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PubMed
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Sodium glucose co-transporter-2 inhibitors (SGLT-2 Is) showed comparable asthma control to metformin, unlike DPP-4 inhibitors and GLP-1 receptor agonists. SGLT-2 Is may be a suitable alternative for managing type 2 diabetes in asthma patients.

Keywords:
AsthmaDipeptidyl peptidase-4 inhibitorsGlucagon-like peptidase 1 receptor agonistsMetforminNational administrative databaseSodium glucose co-transporter-2 inhibitorsType 2 diabetes

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Area of Science:

  • Endocrinology
  • Pulmonology
  • Pharmacology

Background:

  • Antihyperglycemic drugs like DPP-4 Is, GLP-1 RAs, and SGLT-2 Is may influence asthma control through anti-inflammatory and metabolic pathways.
  • Metformin is a common treatment for type 2 diabetes, but its effect on asthma exacerbations is a key comparison point.

Purpose of the Study:

  • To compare the risk of asthma exacerbations in patients with comorbid asthma and type 2 diabetes when treated with novel antihyperglycemic drugs versus metformin.
  • To evaluate the efficacy of DPP-4 Is, GLP-1 RAs, and SGLT-2 Is in managing asthma control in this patient population.

Main Methods:

  • A retrospective cohort study using a Japanese national administrative database (2014-2022).
  • Included 137,173 new users of DPP-4 Is, GLP-1 RAs, SGLT-2 Is, or metformin with a history of asthma and type 2 diabetes.
  • Propensity score weighting was used to balance patient characteristics; primary outcome was the first exacerbation requiring systemic corticosteroids.

Main Results:

  • DPP-4 inhibitors and GLP-1 receptor agonists were associated with a higher incidence of asthma exacerbations requiring systemic corticosteroids compared to metformin.
  • Sodium glucose co-transporter-2 inhibitors demonstrated a similar incidence of exacerbations requiring systemic corticosteroids compared to metformin.
  • SGLT-2 Is were associated with slightly fewer overall exacerbations requiring systemic corticosteroids.

Conclusions:

  • DPP-4 Is and GLP-1 RAs showed poorer asthma control compared to metformin in patients with type 2 diabetes and asthma.
  • SGLT-2 Is provided asthma control comparable to metformin, suggesting they may be a suitable alternative for this patient group.