Tirzepatide pilot trial aims to improve lung function and muscle in overweight/obese COPD patients

Chronic obstructive pulmonary disease (COPD) is a debilitating condition characterized by progressive decline in lung function, systemic inflammation, and skeletal muscle impairment. While obesity was once considered protective in COPD, emerging evidence suggests that excess adiposity and adipokine dysregulation, particularly elevated leptin levels, contribute to chronic inflammation and impaired muscle function. Current therapies primarily address pulmonary symptoms, leaving systemic comorbidities like muscle wasting and inflammation largely unaddressed. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), known for anti-inflammatory and metabolic benefits, offer a promising therapeutic avenue for these systemic aspects of COPD.

The GLIMR COPD study is a prospective, randomized, controlled pilot trial investigating tirzepatide in overweight and obese adults with COPD. Thirty participants will be enrolled at the Cleveland Clinic COPD Center: 20 receiving tirzepatide and 10 age- and sex-matched controls. Tirzepatide-treated participants will undergo standard dose escalation to a maintenance dose of 2.4 mg weekly. Participants will be followed for 12 months, with assessments at screening, baseline, 6 months, and 12 months. The study aims to evaluate effects on lung function, skeletal muscle health, inflammation, and body composition.

As a pilot study design, no results are available yet. However, the study's primary objective is to determine the effect of GLP-1 receptor agonist therapy on skeletal muscle function and physiology over 12 months. Secondary objectives include evaluating changes in body composition, systemic inflammation, adipokine signaling, immune function, pulmonary physiology, physical performance, and treatment tolerability. The study will characterize the effects of GLP-1 therapy on systemic inflammation and immune dysregulation using longitudinal blood-based proteomic analyses and adipokine measurements, including leptin and adiponectin. It also aims to investigate the impact on skeletal muscle health and function, and assess changes in pulmonary physiology and physical performance.