EFFECT OF GLP 1 RECEPTOR AGONISTS ON RESPIRATORY OUTCOMES: AN INVERSE DISPROPORTIONALITY ANALYSIS OF FAERS DATA AND SYSTEMATIC REVIEW WITH META-ANALYSIS OF TYPE 2 DIABETES MELLITUS CLINICAL TRIALS
Author(s)
Christy Thomas1, Krishna Undela, PhD2, Anjali R. K V, M Pharm3, Muhammed Rashid, PhD4, Sajesh Veettil, PhD5, RATHOD MAHESH, Pharm D6;
1NIPER Guwahati Assam, Research Scholar, Changsari, India, 2NIPER Guwahati Assam, Pharmacy Practice, Guwahati, India, 3NIPER, Pharmacy Practice, GUWAHATI, India, 4University of Utah, Salt Lake City, UT, USA, 5International Medical University, Pharmacy Practice, kuala lumpur, Malaysia, 6National Institute of Pharmaceutical Education and Research, Guwahati, Pharmacy Practice, Guwahati, India
1NIPER Guwahati Assam, Research Scholar, Changsari, India, 2NIPER Guwahati Assam, Pharmacy Practice, Guwahati, India, 3NIPER, Pharmacy Practice, GUWAHATI, India, 4University of Utah, Salt Lake City, UT, USA, 5International Medical University, Pharmacy Practice, kuala lumpur, Malaysia, 6National Institute of Pharmaceutical Education and Research, Guwahati, Pharmacy Practice, Guwahati, India
OBJECTIVES: Type 2 diabetes mellitus confers increased respiratory risk through systemic inflammation and metabolic dysfunction. Glucagon like peptide 1 receptor agonists (GLP1 RAs) exhibit pleiotropic anti-inflammatory effects, yet their respiratory safety profile and potential protective associations remain a conflict.
METHODS: An inverse disproportionality analysis of FAERS spontaneous reports and a systematic review with meta-analysis of clinical trials were performed. FAERS outcomes were assessed using Proportional Reporting Ratio (PRR), Upper Bound Reporting Odds Ratio (UB ROR), and Information Component (IC025). PubMed, EMBASE, and Cochrane CENTRAL were searched up to April 2025 for GLP1 RA trials in T2DM patients reporting any respiratory outcomes. Pooled risk ratios (RR) with 95% CI were calculated using a random-effects model for the meta-analysis.
RESULTS: FAERS analysis identified inverse associations for 46 respiratory outcomes with GLP-1 RAs. Out of which, 25 inverse signals retained after active comparator analysis with SGLT2 inhibitors. In 118 clinical trials, GLP-1 RAs overall showed no significant effect on respiratory outcomes. Subgroups based on individual GLP-1 RA revealed semaglutide lowered risk of upper respiratory tract infection (RR: 0.64, 95% CI: 0.51-0.81) and broader respiratory, thoracic and mediastinal disorders (RR: 0.42; 95% CI: 0.27-0.66), while liraglutide reduced sinusitis events (RR: 0.57; 95% CI: 0.37-0.86).
CONCLUSIONS: Among patients using GLP1 RAs, there was a low risk of respiratory outcomes, particularly obstructive disorders. These findings support the potential respiratory safety and clinical benefits to this population.
METHODS: An inverse disproportionality analysis of FAERS spontaneous reports and a systematic review with meta-analysis of clinical trials were performed. FAERS outcomes were assessed using Proportional Reporting Ratio (PRR), Upper Bound Reporting Odds Ratio (UB ROR), and Information Component (IC025). PubMed, EMBASE, and Cochrane CENTRAL were searched up to April 2025 for GLP1 RA trials in T2DM patients reporting any respiratory outcomes. Pooled risk ratios (RR) with 95% CI were calculated using a random-effects model for the meta-analysis.
RESULTS: FAERS analysis identified inverse associations for 46 respiratory outcomes with GLP-1 RAs. Out of which, 25 inverse signals retained after active comparator analysis with SGLT2 inhibitors. In 118 clinical trials, GLP-1 RAs overall showed no significant effect on respiratory outcomes. Subgroups based on individual GLP-1 RA revealed semaglutide lowered risk of upper respiratory tract infection (RR: 0.64, 95% CI: 0.51-0.81) and broader respiratory, thoracic and mediastinal disorders (RR: 0.42; 95% CI: 0.27-0.66), while liraglutide reduced sinusitis events (RR: 0.57; 95% CI: 0.37-0.86).
CONCLUSIONS: Among patients using GLP1 RAs, there was a low risk of respiratory outcomes, particularly obstructive disorders. These findings support the potential respiratory safety and clinical benefits to this population.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO129
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment, Comparative Effectiveness or Efficacy
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)