Asthma exacerbation rates and rescue inhaler use declined following initiation of glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy in adults with asthma and comorbid overweight, obesity, or type 2 diabetes mellitus (T2DM), according to findings presented at the European Congress on Obesity 2026. The nationwide Danish cohort study suggested that GLP-1 RA treatment may be associated with improved asthma-related outcomes in individuals with metabolic disease.
The self-controlled cohort study used linked Danish national health registers to evaluate asthma outcomes before and after initiation of GLP-1 RA therapy. Adult individuals with a prior asthma diagnosis or at least two redeemed asthma inhaler prescriptions within 12 months were included on the date of their first GLP-1 RA prescription. Eligible participants were required to have continuous registration data available for at least 12 months before and after treatment initiation. Individuals with chronic obstructive pulmonary disease or severe asthma treated with biologic therapies were excluded.
The cohort included 27,523 adults with asthma, with a mean age of 54 years; 66% were female. Among the cohort, 49% had overweight or obesity, 61% had T2DM, and 26% had both conditions. Approximately 50% of GLP-1 RA prescriptions were for liraglutide, 48% for semaglutide, and 2% for other agents, including exenatide, dulaglutide, and lixisenatide. Simon Høj, Kjell Erik Julius Håkansson, and colleagues evaluated exacerbations, rescue medication use, inhaled corticosteroid exposure, and lower respiratory tract infection events.
The primary outcome was asthma exacerbation, defined as asthma-related hospitalization and/or treatment with systemic oral or intravenous corticosteroids. Compared with the year before GLP-1 RA initiation, treatment was associated with a 26% lower exacerbation rate overall. Exacerbation reductions reached 28% in men and 23% in women. When stratified by treatment indication, exacerbation rates decreased by 22% in individuals with overweight or obesity and by 26% in those with T2DM.
Use of rescue inhaled short-acting β2-agonists decreased by 14% during treatment. Inhaled corticosteroid exposure also declined by 23%, suggesting lower symptom burden despite reduced corticosteroid use. Pneumonia events decreased by 10%. Similar reductions in exacerbation rates were observed among individuals with and without allergic rhinitis.
The authors stated: “In this nationwide cohort of over 27,000 individuals with asthma and also overweight, obesity or type 2 diabetes, use of GLP-1 drugs was associated with significant reductions in exacerbation burden as well as reliever use, exposure to inhaled corticosteroids and pneumonia events, irrespective of whether the drugs were being used to treat obesity or type 2 diabetes.”
The authors noted that the analysis did not include direct clinical data such as body mass index (BMI) measurements or weight-loss outcomes. According to Kjell Erik Julius Håkansson, “There's a high chance that the weight loss is a major contributor to these results.” He added that excess adipose tissue may contribute to systemic inflammation and shortness of breath in both obesity and asthma, and noted that obesity-related inflammation may differ from the inflammation seen in classic eosinophilic asthma.
Dr Håkansson also stated: “As the use of GLP-1 therapies increases, researchers are finding an increasing number of effects outside of weight loss.”
