GLP-1 receptor agonist use linked to fewer asthma exacerbations in adolescents with overweight or obesity

An association between use of glucagonlike peptide-1 receptor agonists (GLP-1RAs) and a lower risk of acute asthma exacerbations among adolescents with overweight or obesity was observed in a recent research letter published in JAMA Network Open. The findings address an important evidence gap as GLP-1RAs are increasingly prescribed for weight management in adolescents, according to the authors of the research letter.

Overweight and obesity are established risk factors for greater asthma severity and more frequent exacerbations during adolescence. Prior observational studies in adults have suggested potential respiratory benefits with GLP-1RA therapy, but results have been inconsistent, and no dedicated studies had previously evaluated adolescents. The current analysis sought to determine whether GLP-1RA use was associated with fewer asthma-related events in a real-world adolescent cohort.

Study design and population

Investigators conducted a retrospective cohort study using data from the TriNetX global federated health research network, covering January 1, 2020, through July 1, 2025. The study population included adolescents aged 12 to 18 years with concurrent diagnoses of asthma and overweight or obesity, with or without diabetes. Patients who received a new prescription for a GLP-1RA were compared with a control group receiving documented nonpharmacological weight management interventions.

Using 1:1 propensity score matching, the authors balanced baseline demographic characteristics, body mass index categories, asthma severity proxies, and prior use of asthma- and diabetes-related medications. After matching, 1070 adolescents were included, with 535 patients in each group. The mean (SD) age was 15.8 (2.1) years; 608 participants (56.8%) were female, and 462 (43.2%) were male. Baseline characteristics were reported as well-balanced between groups.

The primary outcome was the incidence of acute asthma exacerbation, defined using relevant ICD-10 diagnosis codes. Systemic corticosteroid prescriptions and emergency department visits for asthma were listed as secondary outcomes.

Reduced exacerbations and asthma-related health care use

During 12 months of follow-up, acute asthma exacerbations occurred significantly less frequently among adolescents receiving GLP-1RAs compared with controls. Exacerbations were reported in 29 patients (5.4%) in the GLP-1RA group versus 57 patients (10.7%) in the control group, corresponding to a relative risk of 0.51 (95% CI, 0.33-0.78; P = .002).

Emergency department visits for asthma were less common in the GLP-1RA group than in controls (8 [1.5%] vs 19 [3.6%]; relative risk, 0.42 [95% CI, 0.19-0.95]; P = .04). Prescriptions for systemic corticosteroids were also reduced (111 [20.7%] vs 168 [31.4%]; relative risk, 0.66 [95% CI, 0.54-0.81]; P < .001).

Prescriptions for inhaled short-acting beta-2 agonists occurred less frequently among patients receiving GLP-1RAs compared with controls (173 [32.3%] vs 239 [44.7%]; relative risk, 0.72 [95% CI, 0.62-0.84]; P < .001). Among adolescents who experienced at least one exacerbation, the mean (SD) number of subsequent events over 12 months was similar between groups (1.83 [1.49] vs 2.02 [1.98]; P = .65).

Interpretation and limitations

The authors noted that this is the first study, to their knowledge, reporting an association between GLP-1RA use and a lower risk of acute asthma exacerbations in adolescents with overweight or obesity. The findings suggest a potential dual benefit in this population, addressing both weight management and asthma morbidity.

However, the study’s retrospective and observational design precludes causal inference. Because the analysis relied on body mass index categories rather than longitudinal weight change, the investigators could not determine whether the observed benefits were driven by weight loss or by weight-independent anti-inflammatory effects of GLP-1RAs. Additional limitations included the potential for residual confounding and the predominance of U.S.-based data, which may limit generalizability.

The authors concluded that prospective randomized clinical trials are needed to confirm efficacy and safety of GLP-1RAs as an adjunct asthma therapy in adolescents with overweight or obesity.

Reference:

Huang Y, Tsai M, Lin TCC, Fu L. Glucagonlike Peptide-1 Receptor Agonists and Asthma Risk in Adolescents With Obesity. JAMA Netw Open. 2025;8(12):e2551611. doi:10.1001/jamanetworkopen.2025.51611