SGLT2 inhibitors help ward off asthma

Patients on sodium-glucose co-transporter (SGLT) 2 inhibitors are less likely to develop asthma compared with those on dipeptidyl peptidase (DPP)-4 inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1RAs), a study has found.

Researchers conducted a network meta-analysis and searched multiple online databases for placebo-controlled cardiovascular or cardiorenal outcome trials that evaluated the incidence of asthma among patients receiving treatment with glucose-lowering drugs such as DPP-4 inhibitors, GLP-1RAs, or SGLT2 inhibitors.

A total of 19 trials that involved 218 incident asthma cases among 159,705 patients were selected for inclusion. Pooled data, obtained using a random effects network meta-analysis, showed that the odds of asthma were lower among users of SGLT2 inhibitors than those on placebo (odds ratio [OR], 0.59, 95 percent confidence interval [CI], 0.38–0.93).

On the other hand, both DPP-4 inhibitors and GLP-1RAs had a null effect on asthma risk as compared with placebo.

When comparing diabetes medications, SGLT2 inhibitors remained associated with a significantly lower risk of asthma relative to DPP-4 inhibitors (OR, 0.38, 95 percent CI, 0.18–0.79). There was no difference in the risk observed between GLP-1RAs and DPP-4 inhibitors and between SGLT2 inhibitors and GLP-1RAs.

More studies are needed to establish the beneficial effect of SGLT2 inhibitors on the risk of asthma and identify the mechanisms underlying such a benefit, given the underreporting of asthma in the trials included in the meta-analysis.