Obesity is a known risk factor for poor asthma control in adolescents, contributing to more frequent and severe exacerbations. Although glucagonlike peptide-1 receptor agonists (GLP-1RAs) are widely prescribed for weight management, their effect on asthma outcomes in adolescents has not been well established. To address this evidence gap, researchers evaluated whether GLP-1RA use is associated with a reduced risk of acute asthma exacerbations in this population.
The study, published in JAMA Network Open, was led by Yung-Chieh Huang of the Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Taichung Veterans General Hospital, Taiwan. Investigators analysed data from the TriNetX global health research network between January 2020 and July 2025. Adolescents aged 12 to 18 years with asthma and overweight or obesity were included, with or without diabetes.
Patients newly prescribed GLP-1RAs were compared with matched controls receiving nonpharmacological weight-management interventions. Using 1:1 propensity score matching, the groups were balanced for demographic factors, BMI categories, asthma severity indicators, and prior medication use. The primary outcome was acute asthma exacerbation, while secondary outcomes included emergency department visits and systemic corticosteroid prescriptions.
The study revealed the following findings:
- The matched analysis included 1,070 adolescents, with 535 patients in each group.
- Over 12 months, acute asthma exacerbations were significantly less frequent in adolescents treated with GLP-1 receptor agonists compared with controls.
- Asthma-related emergency department visits occurred less often among GLP-1RA users.
- Use of systemic corticosteroids was lower in the GLP-1RA group, reflecting reduced exacerbation severity.
- Prescriptions for short-acting beta-2 agonists were also less common, indicating better symptom control.
- Among adolescents who experienced at least one exacerbation, the number of subsequent episodes over one year was similar between groups, suggesting GLP-1RAs primarily reduced the risk of initial exacerbations rather than recurrence.
The authors highlighted that this is the first study to link GLP-1RA use with a lower risk of asthma exacerbations in adolescents with overweight or obesity. The findings suggest a potential dual benefit, addressing both weight management and asthma control.
However, the researchers cautioned that the study’s retrospective design limits causal interpretation. The analysis relied on BMI categories rather than longitudinal weight changes, making it unclear whether the benefits were driven by weight loss or direct anti-inflammatory effects. Residual confounding and limited generalisability were also noted.
"Overall, the results support further investigation of GLP-1 receptor agonists as a possible adjunct therapy for asthma in adolescents with overweight or obesity, with confirmation needed through prospective randomised trials," the authors concluded.
Reference:
Huang Y, Tsai M, Lin TCC, Fu L. Glucagonlike Peptide-1 Receptor Agonists and Asthma Risk in Adolescents With Obesity. JAMA Netw Open. 2025;8(12):e2551611. doi:10.1001/jamanetworkopen.2025.51611
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