GLP-1 receptor agonists reduced asthma exacerbations among adults with asthma and excess weight but without diabetes in real-world study of more than 3000 individuals, presented at the American Academy of Allergy, Asthma & Immunology (AAAAI) 2026 Annual Meeting.

“Asthma exacerbations can be disruptive for patients, especially those living with obesity, who often have fewer effective treatment options,” senior author Ruchi Patel, MD, internal medicine resident at Rutgers New Jersey Medical School, Newark, New Jersey, told Medscape Medical News. 

“We know obesity worsens asthma outcomes, but we do not have many targeted therapies that address both metabolic dysfunction and airway inflammation,” Patel said. GLP-1 receptor agonists are widely used for both diabetes and weight management, and preclinical data suggest GLP-1 signaling may also reduce airway inflammation, Patel added.

In the new study, Patel and colleagues used data from the global collaborative network TriNetX to compare asthma exacerbation rates over a 3-year period between adults with excess weight but without diabetes who did and did not use a GLP-1 receptor agonist.

The study population included 710 individuals with overweight (BMI, 25.0-29.99), 1515 with obesity (BMI, 30-40), and 1249 with morbid obesity (BMI ≥ 40).

Use of a GLP-1 receptor agonist was associated with reductions in risk for asthma exacerbations, with risk differences of 14.6% (risk ratio [RR], 0.748), 12.2% (RR, 0.790), and 13.3% (RR, 0.780) for the overweight, obesity, and morbid obesity groups, respectively. The results were statistically significant across all weight classes (P < .0001 for all).

“What was most striking was the consistency of the effect across overweight, obese, and morbidly obese groups,” Patel told Medscape Medical News. “We expected weight loss to play a role, but the similar magnitude of risk reduction across BMI categories suggests there may be additional mechanisms beyond just mechanical weight reduction,” she said.

The study was limited by several factors including the observational design, lack of data on GLP-1 use duration, and the potential for residual confounding due to weight loss.

“I would be eager to see prospective randomized trials in nondiabetic patients with obesity-associated asthma in order to determine whether GLP-1 therapies directly improve asthma outcomes and to better understand the underlying mechanisms,” said Patel.

However, the results suggest added respiratory benefits of GLP-1 receptor agonists beyond their metabolic effects in patients with obesity and asthma, said Patel. “This highlights a potentially promising therapeutic avenue that deserves prospective study,” she said.

Data Beyond Diabetes

Most previous research evaluating the association between GLP-1 use and asthma exacerbations has involved individuals with diabetes, and the current study is important in helping to determine whether similar benefits extend to patients without diabetes, said Arianne K. Baldomero, MD, pulmonologist and assistant professor of medicine at the University of Minnesota, Minneapolis.

The finding that GLP-1 is associated with decreased asthma exacerbations in nondiabetic patients with overweight or obesity was not unexpected, said Baldomero, who was not involved in the study. “Prior observational studies in diabetic populations have shown similar reductions, likely related to anti-inflammatory effects, although mechanisms remain unclear,” she noted.

GLP-1 therapies are not currently FDA-approved for asthma, and use should remain guided by existing indications, Baldomero told Medscape Medical News. However, the takeaway remains that GLP-1 use is associated with reduced asthma exacerbations in patients with overweight/obesity, regardless of diabetes status, she said.

More research is needed clarify whether the benefits to asthma associated with GLP-1 use are driven by weight loss, glycemic control, or other mechanisms, Baldomero added. “Studies also should evaluate effects in patients without diabetes or obesity, and better characterize potential risks in these populations,” she said.

The study was supported by the Margaret Wolf Pulmonary Research Fund. The researchers and Baldomero had no financial conflicts to disclose.