Chronic obstructive pulmonary disease: potential new treatments

Drugs known for their favourable cardiovascular effects may also benefit the respiratory system. There has been interest in exploring whether such treatments could therefore provide relief for the estimated 1.2 million people living across the UK with chronic obstructive pulmonary disease (COPD)—a disabling lung condition.

Pradhan et al (2022) examined whether the use of the receptor agonist glucagon-like peptide 1 (GLP-1), dipeptidyl peptidase 4 (DPP-4) inhibitors, and sodium-glucose co-transporter-2 (SGLT-2) inhibitors, separately, are associated with a lower risk of COPD exacerbations among a patient cohort with COPD and type 2 diabetes.

The researchers assessed factors such as whether each drug was linked with, for example, a decreased risk of developing a moderate exacerbation (the researchers defined this as a co-prescription of an oral corticosteroid and an antibiotic, along with an outpatient diagnosis of acute COPD exacerbation that same day). The results showed that when compared with sulfonylureas, GLP-1 receptor agonists were found to be associated with a 30% reduced risk of a severe exacerbation (3.5 v 5.0 events per 100 person years) and moderate exacerbation. DPP-4 inhibitors were also observed to be associated with a modestly decreased incidence of severe exacerbation (4.6 v 5.1 events per 100 person years) and moderate exacerbation. The team also observed that SGLT-2 inhibitors were associated with a 38% lower risk of severe exacerbation (2.4 v 3.9 events per 100 person years), but these were not seen to have any effect on the risk of developing moderate exacerbation.