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Chronic obstructive pulmonary disease
Original research
Glucagon-like peptide-1 receptor agonists may benefit cardiopulmonary outcomes in patients with COPD
  1. Fu-Shun Yen1,
  2. Chih-Cheng Hsu2,
  3. James Cheng-Chung Wei3,
  4. Fuu-Jen Tsai4,
  5. Yuhan Huang5,
  6. Teng-Shun Yu5,
  7. Chii-Min Hwu6
  1. 1Dr Yen’s Clinic, Taoyuan, Taiwan
  2. 2Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
  3. 3Department of Allergy, Chung Shan Medical University Hospital, Taichung, Taiwan
  4. 4China Medical University College of Chinese Medicine, Taichung, Taiwan
  5. 5Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
  6. 6Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan
  1. Correspondence to Dr Chii-Min Hwu; chhwu{at}vghtpe.gov.tw

Abstract

Background Clinical studies have shown that glucagon-like peptide-1 receptor agonists (GLP-1 RA) can have beneficial effects on cardiopulmonary function. We conducted this longitudinal cohort study to compare the risk of cardiopulmonary outcomes and mortality between GLP-1 RA use and no use in patients with type 2 diabetes (T2D) and chronic obstructive pulmonary disease (COPD).

Methods The study identified 8060 matched GLP-1 RA users and non-users from Taiwan’s National Health Insurance Research Database from 1 January 2008 to 31 December 2019. Cox proportional hazards models were used to determine the risk of cardiopulmonary outcomes between GLP-1 RA users and non-users.

Results The mean follow-up time was 2.51 and 2.46 years for GLP-1 RA users and non-users, respectively. In the matched cohorts, GLP-1 RA users had a significantly lower risk of mortality (adjusted HR (aHR) 0.46, 95% CI 0.38 to 0.56), cardiovascular events (aHR 0.73, 95% CI 0.65 to 0.82), non-invasive positive pressure ventilation (aHR 0.66, 95% CI 0.47 to 0.93), invasive mechanical ventilation (aHR 0.64, 95% CI 0.51 to 0.8) and bacterial pneumonia (aHR 0.76, 95% CI 0.65 to 0.88) than GLP-1 RA non-users. The subsequent analyses for various subgroup and medication duration also showed that GLP-1 RA was associated with a significantly lower risk of mortality, cardiovascular events, ventilation support and bacterial pneumonia than non-GLP-1 RA.

Conclusion This nationwide cohort study showed that GLP-1 RA had a lower risk of cardiopulmonary outcomes and all-cause mortality than non-GLP-1 RA in patients with T2D and COPD. GLP-1 RA may help manage diabetes in people with COPD.

  • Assisted Ventilation
  • Pneumonia
  • COPD Exacerbations
  • Emphysema
  • Lung Cancer
  • Non invasive ventilation

Data availability statement

No data are available. Data of this study are available from the National Health Insurance Research Database (NHIRD) published by Taiwan National Health Insurance (NHI) Administration. The data used in this study cannot be made available in the paper, the supplemental files or in a public repository due to the ‘Personal Information Protection Act’ executed by Taiwan government starting from 2012. Requests for data can be sent as a formal proposal to the NHIRD office (https://dep.mohw.gov.tw/DOS/cp-2516-3591-113.html) or by email to stsung@mohw.gov.tw.

https://doi.org/10.1136/thorax-2023-221040

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    Data availability statement

    No data are available. Data of this study are available from the National Health Insurance Research Database (NHIRD) published by Taiwan National Health Insurance (NHI) Administration. The data used in this study cannot be made available in the paper, the supplemental files or in a public repository due to the ‘Personal Information Protection Act’ executed by Taiwan government starting from 2012. Requests for data can be sent as a formal proposal to the NHIRD office (https://dep.mohw.gov.tw/DOS/cp-2516-3591-113.html) or by email to stsung@mohw.gov.tw.

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    Footnotes

    • F-SY and C-CH contributed equally.

    • Contributors F-SY: study concept and design, drafting of the manuscript; revision of the manuscript for crucial intellectual content; study supervision. JC-CW: revision of the manuscript for crucial intellectual content; technical or material support; study supervision. T-SY and YH: data acquisition, analysis and interpretation; statistical analysis. C-MH: study concept and design; data acquisition, analysis and interpretation; drafting of the manuscript; revision of the manuscript for crucial intellectual content; statistical analysis; obtained funding; technical or material support; study supervision. C-CH: analysis and interpretation of data; drafting of the manuscript; revision of the manuscript for crucial intellectual content. C-MH and C-CH are the guarantors.

    • Funding This study is supported in part by Taiwan Ministry of Health and Welfare Clinical Trial Center (MOHW112-TDU-B-212-144004), China Medical University Hospital (DMR-111-105; DMR-112-087), Taipei Veterans General Hospital (V110C-175, V111C-188, V112C-164) and the National Science and Technology Council, ROC (MOST 110-2314-B-075-027-MY3), Taiwan.

    • Disclaimer The interpretation and conclusions of the data reported here do not represent the position of the NHI Administration. The funders had no role in the study design, data collection and analysis, the decision to publish, or preparation of the manuscript.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.