A BSTRACT Background: Glucagon-like peptide-1 receptor agonists (GLP-1RA), initially developed to control type 2 diabetes mellitus, have gained recognition for their broad cardiometabolic benefits, including weight loss, and cardiovascular protection. Emerging evidence indicates that these agents may also improve respiratory outcomes through their anti-inflammatory effects, bronchodilation, and weight reduction effects. This systematic review aimed to evaluate the indications, efficacy, and safety of GLP-1RA in respiratory diseases. Methods: The review was conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of PubMed, Embase, and Clinical Trials was conducted to identify studies published between 2010 and May 2025. Randomized controlled studies that evaluated the effects of GLP-1RA on respiratory parameters in patients with asthma, chronic obstructive pulmonary disease (COPD), or obstructive sleep apnea (OSA) were assessed and quality assessment was conducted using the Joanna Briggs Institute appraisal tool. Details about indications, outcomes like lung function, symptomatic relief, and inflammatory markers, and safety were collected. Results: A total of 434 records were identified, and after screening and assessments, five randomized controlled trials comprising 1,034 participants were included. Four studies evaluated liraglutide and one assessed tirzepatide in patients with obesity-related pulmonary diseases, OSA, or COPD. Liraglutide significantly reduced apnea–hypopnea index (AHI) and improved forced vital capacity, oxygen saturation, and COPD Assessment Test scores ( P < 0.05). It also lowered body mass index ( P < 0.001) and surfactant protein-D levels ( P < 0.038). Tirzepatide also reduced AHI and hypoxic burden ( P < 0.001) and improved patient-reported sleep outcomes ( P < 0.001). Conclusion: In summary, GLP-1 receptor agonists improve the outcomes in patients with OSA, COPD, and obesity-related pulmonary diseases, especially those with obesity, or type 2 diabetes. Therefore, these agents can be used as adjunctive therapy alongside standard treatments particularly in presence of diabetes or obesity. Larger, long-term trials are needed to confirm their efficacy and safety across respiratory diseases.
Esmaeel et al. (Sun,) studied this question.