The relationship between the use of GLP-1 receptor agonists and the incidence of respiratory illness: a meta-analysis of randomized controlled trials

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Abstract
Aim: We aimed to assess the association between the use of Glucagon-like peptide-1 receptor agonists and the risk of 12 respiratory diseases in patients with type 2 diabetes, obesity, or overweight. Method: The PubMed (MEDLINE), EMBASE, Cochrane Library, and ClinicalTrials.gov databases were searched from the establishment of the database to December 24, 2022. Dichotomous outcomes were analyzed using RR and 95% CI calculated from fixed-effects models. Results: Twenty-eight RCTs were ultimately included for analysis, involving a total of 77,485 participants. Compared to controls, patients with GLP-1RAs have a 14% lower risk of respiratory disease (RR 0.86, 95% CI 0.81–0.93 p < 0.0001), with Semaglutid (RR 0.82, 95% CI 0.68–0.97, p = 0.02), Liraglutide (RR 0.86. 95% CI 0.75–0.98, p = 0.03), Dulaglutide (RR 0.82, 95% CI 0.70–0.96, p = 0.02), Albiglutide (RR 0.93,95% CI 0.79–1.10, p = 0.40), Exenatide (RR 0.93, 95% CI 0.74–1.18, p = 0.55), Lixisenatide (RR 0.83, 95% CI 0.62–1.12, p = 0.22), and Efpeglenatide (RR 0.76, 95% CI 0.46–1.24, p = 0.27). Semaglutide, Liraglutide and Dulaglutide reduce the risk of respiratory diseases by 18%, 14% and 18%, respectively.Trial duration, control type, and indication were not associated with the impact of GLP-1 receptor agonists on overall respiratory disease. Among secondary outcomes, the risk of Pulmonary edema (RR 0.66, 95% CI 0.44–0.98, p = 0.04), and Bronchitis (RR 0.86, 95% CI 0.74–1.00, p = 0.04) was reduced. Conclusion: In conclusion, GLP-1RAs were linked to a lower risk of overall respiratory diseases, especially Pulmonary edema and Bronchitis. In the future, physicians should pay attention to the relationship between GLP-1 RA and the risk of respiratory diseases and evaluate the efficacy of GLP-1RAs in the primary and secondary prevention of respiratory diseases. Trial registration CRD42023396138. Graphical

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