For sufferers with kind 2 diabetes (T2D) and persistent obstructive pulmonary dysfunction (COPD), sodium-glucose cotransporter-2 inhibitors (SGLT-2is) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are related to a diminished danger for average or extreme COPD exacerbations in contrast with dipeptidyl peptidase 4 inhibitors (DPP-4is), in line with a research revealed on-line Feb. 10 in JAMA Inside Drugs.
Avik Ray, M.D., from Brigham and Ladies’s Hospital and Harvard Medical College in Boston, and colleagues performed a comparative effectiveness research to evaluate the danger for average or extreme COPD exacerbations amongst sufferers aged 40 years or older with T2D and energetic COPD who initiated therapy with SGLT-2is versus DPP-4is; GLP-1 RAs versus DPP-4is; and SGLT-2is versus GLP-1 RAs (27,991; 32,107; and 36,218 pairs, respectively).
The researchers discovered that the danger for average or extreme COPD exacerbation was decrease amongst these handled with SGLT-2is versus DPP-4is and amongst these handled with GLP-1 RAs versus DPP-4is (9.26 versus 11.4 per 100 person-years [hazard ratio, 0.81] and 9.89 versus 11.49 per 100 person-years [hazard ratio, 0.86]respectively), with minimal variations noticed amongst these handled with SGLT-2is versus GLP-1 RAs. Throughout sensitivity and subgroup analyses, the outcomes have been constant.
“These findings recommend that SGLT-2is and GLP-1 RAs could also be preferable to DPP4is when deciding amongst glucose-lowering drugs for sufferers with T2D and energetic COPD,” the authors write. “Nonetheless, given the observational nature of the research, there’s potential for residual or unmeasured confounding, and findings from comparable scientific research and scientific trials will assist corroborate these outcomes.”
A number of authors disclosed ties to the pharmaceutical business; one creator disclosed being an professional witness in litigation in opposition to inhaler producers.
Extra data:
Avik Ray et al, Glucose-Decreasing Medicines and Danger of Power Obstructive Pulmonary Illness Exacerbations in Sufferers With Sort 2 Diabetes, JAMA Inside Drugs (2025). DOI: 10.1001/jamainternmed.2024.7811
Nathan M. Stall et al, Pleotropic Results of Glucose-Decreasing Medicines—Want for Cautious Interpretation of Goal Trial Emulation Research, JAMA Inside Drugs (2025). DOI: 10.1001/jamainternmed.2024.7812
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