GLP-1 receptor agonists improve outcomes in obstructive sleep apnea, COPD, and obesity-related pulmonary diseases

While glucagon-like peptide-1 receptor agonists (GLP-1RA) are well-established for managing Type 2 diabetes mellitus and obesity, their potential benefits in respiratory diseases are an emerging area of interest. Traditional treatments for conditions like obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) often fall short, especially in patients with co-morbid obesity. GLP-1RAs offer a unique therapeutic angle through their anti-inflammatory, bronchodilatory, and weight-reducing effects, potentially addressing underlying mechanisms contributing to respiratory dysfunction beyond glycemic control.

This systematic review, adhering to PRISMA guidelines, evaluated the efficacy and safety of GLP-1RAs in respiratory diseases. Researchers conducted a comprehensive search of PubMed, Embase, and Clinical Trials for studies published between 2010 and May 2025. The review included five randomized controlled trials (RCTs) comprising 1,034 participants. These trials assessed the effects of GLP-1RAs on respiratory parameters in patients with obesity-related pulmonary diseases, OSA, or COPD. Quality assessment was performed using the Joanna Briggs Institute appraisal tool, focusing on lung function, symptomatic relief, inflammatory markers, and safety.

The systematic review identified five RCTs involving 1,034 participants, with four studies evaluating liraglutide and one assessing tirzepatide. Both GLP-1RAs demonstrated significant improvements across various respiratory outcomes. Liraglutide consistently reduced the apnea-hypopnea index (AHI) and improved forced vital capacity (FVC), oxygen saturation, and COPD Assessment Test (CAT) scores (P < 0.05). It also led to a significant reduction in body mass index (BMI) (P < 0.001) and lowered surfactant protein-D levels (P < 0.038), indicating reduced lung inflammation. > Tirzepatide similarly reduced AHI and hypoxic burden (P < 0.001), alongside improving patient-reported sleep outcomes (P < 0.001), showcasing its dual GLP-1R and GIPR agonism benefits. The findings suggest a broad positive impact of GLP-1RAs on respiratory function and related systemic markers.