TOPLINE:

The use of GLP-1 receptor agonists (GLP-1 RAs) was associated with a lower risk for serious infections — particularly respiratory, skin and soft tissue, musculoskeletal, and vascular infections as well as SARS-CoV-2 infections. 

METHODOLOGY:

• Researchers conducted a meta-analysis of randomized clinical trials identified through systematic searches of clinical databases (from inception to September 24, 2024) to assess whether GLP‑1 RAs can reduce the risk for infections.
• Trials with GLP-1 RAs — exenatide, albiglutide, dulaglutide, efpeglenatide, liraglutide, semaglutide, lixisenatide, or tirzepatide — and those that reported infections as serious adverse events were considered.
• They included data from 136 trials involving 164,322 participants (mean age, 56.2 years; 41.1% women; 78.7% with type 2 diabetes; mean A1c, 7.8%). Of these, 92,192 received GLP-1 RA treatment and 72,130 received placebo or active control treatment.
• The primary outcome was incidence of serious infections. Additional analysis examined the impact of GLP-1 RAs on organ system-specific infections, SARS-CoV-2 infections, and infections stratified by severity.

TAKEAWAY:

• Treatment with GLP-1 RAs was associated with a reduced risk for serious infections (risk ratio [RR], 0.89; 95% CI, 0.86-0.93), nonserious infections (RR, 0.90; 95% CI, 0.85-0.97), and infections classified as important medical events (RR, 0.87; 95% CI, 0.81-0.92).
• Similarly, treatment with GLP-1 RAs was associated with a decreased risk for serious respiratory (RR, 0.84), skin and subcutaneous (RR, 0.77), musculoskeletal (RR, 0.79), and vascular (RR, 0.65) infections and serious SARS-CoV-2 infections (RR, 0.82) compared with control treatment.
• Among specific GLP-1 RAs, subcutaneous semaglutide and tirzepatide were associated with a reduced risk for serious infections, whereas liraglutide, oral semaglutide, dulaglutide, exenatide, lixisenatide, albiglutide, and efpeglenatide were not.

IN PRACTICE:

“Our findings highlight the potential of GLP-1 RAs in decreasing infection risk, one of the leading causes of mortality globally,” the authors wrote.

“Additionally, improvements in glycemic control and weight may partially explain this protective effect, though further mechanistic research is warranted,” they added.

SOURCE:

The study was led by Shumeng Han, MM, Department of Endocrinology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. It was published online on October 28, 2025, in the Journal of Infection.

LIMITATIONS:

Infections may have been underreported because most trials were not designed to capture infection outcomes. Individual patient‑level data and the exact timing of events were not available, limiting precision. Subclassifications of system‑specific infections were not possible due to a limited number of events.

DISCLOSURES:

The study received support from the National Natural Science Foundation of China, CAMS Innovation Fund for Medical Sciences, National High Level Hospital Clinical Research Funding, and other organizations. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.