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Glucagon-like peptide-1 receptor agonists linked to a reduced risk of developing asthma among patients with type 2

Yung-Sheng Cheng^1,2, Chi-Hsiang Chung^3,4,5, Shih-Ming Kuo¹

¹Division of Pediatric Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan, ROC.

Therapeutic Advances in Endocrinology and Metabolism

|December 22, 2025

Abstract

Background:

Studies have suggested that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may modulate asthma-related immune pathways, but evidence directly linking the use of GLP-1 RAs to asthma onset remains limited.

Objectives:

We aimed to evaluate whether the use of GLP-1 RAs in patients with type 2 diabetes mellitus (T2DM) is associated with a reduced risk and severity of asthma development.

Design:

This retrospective cohort study was designed to evaluate asthma onset and severity in patients with T2DM treated with GLP-1 RAs, using data from the National Health Insurance Database (2011-2015).

Methods:

Asthma onset and severity were evaluated in 1345 patients with T2DM treated with GLP-1 RAs from a cohort of 1,936,512 individuals, excluding those with pre-existing asthma. Asthma risk was assessed across four severity levels.

Results:

The study demonstrated a mean follow-up duration of 2.92 ± 1.82 years. Notably, treatment with GLP-1 RAs significantly reduced asthma risk compared with the non-GLP-1 RA group, as indicated by an adjusted hazard ratio (HR) of 0.67 (95% confidence interval (CI), 0.45-0.76), suggesting a consistent class effect. A protective trend was observed across various severity levels of asthma. The HRs for the GLP-1 RA group compared with the non-GLP-1 RA group for cases with no acute exacerbations (No-AE), acute exacerbations (AE), and status asthmaticus (Status) were 0.55 (95% CI, 0.37-0.62), 0.59 (95% CI, 0.39-0.66), and 0.83 (95% CI, 0.56-0.93), respectively. However, in cases requiring endotracheal intubation, the HR was 0.96 (95% CI, 0.65-1.09).

Conclusion:

Our study highlights a consistent effect of GLP-1 RAs in reducing asthma risk and severity, except in cases requiring endotracheal intubation, suggesting that GLP-1 RAs may contribute to reducing asthma incidence and severity in patients with T2DM.

Keywords:

acute exacerbation asthma glucagon-like peptide-1 receptor agonists reduce risk type 2 diabetes mellitus

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