B101-09 GLP1 Receptor Agonists and Respiratory Outcomes in Obese Adults With Asthma and Obstructive Sleep Apnea

Abstract Background Glucagon-like peptide-1 receptor agonists (GLP-1RAs), including semaglutide, liraglutide, and tirzepatide, are increasingly prescribed for weight management in patients with obesity. Given the intersection between obesity, asthma, and obstructive sleep apnea (OSA), we sought to evaluate the impact of GLP-1RA use on asthma severity and related outcomes in obese adults with asthma and OSA. Methods We conducted a retrospective cohort study using the TriNetX Global Collaborative Network. Adults with documented diagnoses of obesity (ICD-10: E66), asthma (ICD-10: J45), and OSA (ICD-10: G47.33) were identified. Patients prescribed GLP-1RAs (semaglutide RxNorm: 1991302, liraglutide RxNorm: 475968, or tirzepatide RxNorm: 2601723) formed the exposure cohort. A control group of non-GLP-1RA-users with similar clinical characteristics was selected using 1:1 propensity score matching. Key outcomes included asthma exacerbation, asthma severity progression, emergency department (ED) visits, hospitalizations, new OSA diagnoses, and all-cause mortality. Time-to-event analyses were performed using Cox proportional hazards models, and hazard ratios (HRs) with 95% confidence intervals (CIs) were reported. Results After propensity score matching, each cohort included 332,958 adults (mean age 54 years, 60% female, 69% White, and 20% Black or African American). GLP-1RA users experienced a significantly lower hazard of asthma exacerbation (HR 0.92, 95% CI 0.91-0.92), suggesting reduced flare-up frequency. Progression to more severe asthma phenotypes was also less common among GLP-1RA users (HR 0.78, 95% CI 0.77-0.79), indicating a potential disease-modifying effect. Reductions in healthcare utilization were observed, including lower risks of ED visits (HR 0.89, 95% CI 0.88-0.89) and hospitalizations (HR 0.58, 95% CI 0.58-0.59), reflecting improved disease control. All-cause mortality was significantly lower in the GLP-1RA group (HR 0.40, 95% CI 0.39-0.41), further underscoring the systemic benefit of these agents. Notably, a slight increase in the hazard of new OSA diagnosis was observed (HR 1.22, 95% CI 1.21-1.23), which may reflect increased diagnostic surveillance or unmasking of pre-existing but undiagnosed OSA. Conclusions Among obese adults with asthma and OSA, GLP-1RA use was associated with improved asthma outcomes, reduced healthcare utilization, and significantly lower mortality. These findings suggest GLP-1RAs may offer a therapeutic advantage beyond weight control in patients with respiratory comorbidities. Further prospective trials are warranted to confirm these findings and explore underlying mechanisms. This abstract is funded by: None