---
title: "GLP-1–based Therapy Linked to Fewer Asthma Events in Adults with Obesity: Retrospective Propensity"
id: "pubmed-42733229"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42733229"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42733229/"
doi: "10.1080/17476348.2026.2730537"
published_at: "2026-09-23T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# GLP-1–based Therapy Linked to Fewer Asthma Events in Adults with Obesity: Retrospective Propensity
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42733229
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42733229/)
- **DOI:** [10.1080/17476348.2026.2730537](https://doi.org/10.1080%2F17476348.2026.2730537)
- **Published At:** 2026-09-23T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Background: Obesity worsens asthma morbidity and observational links between **GLP-1**-based therapies and respiratory outcomes may be biased by treatment selection. - Design: Active-comparator, retrospective cohort study using the TriNetX US Collaborative Network across 72 healthcare organizations; adults with BMI ≥30 kg/m2, documented asthma, and initiation of GLP-1-based therapy were compared to patients initiating active non-GLP pharmacologic weight-management therapy. - Matching: 1:1 propensity-score matching produced two cohorts of 2,423 patients each. Outcomes were evaluated from day 1 through day 365 after an aligned index event. - Primary respiratory outcome: Recorded asthma exacerbation occurred in 1.7% of the GLP-1 cohort versus 4.0% in the comparator cohort. Risk difference was −2.2% (95% CI, −3.2% to −1.3%); risk ratio 0.438 (95% CI, 0.306–0.626). - Secondary/utilization outcomes: Lower systemic glucocorticoid exposure in GLP-1 group (16.4% vs 23.1%; RR 0.712). Emergency department/critical-care utilization was reduced (7.1% vs 13.0%; RR 0.541). Acute respiratory failure incidence was lower (0.7% vs 1.8%; RR 0.364). - Sensitivity analyses: BMI- and HbA1c-restricted sensitivity analyses were generally directionally concordant with primary results. - Safety and exposure: **GLP-1**-specific adverse events were not systematically assessed. Treatment persistence and potential exposure/outcome misclassification were not resolved by the dataset. - Interpretation: GLP-1-based therapy was associated with fewer one-year recorded respiratory events and lower acute-care utilization compared with active non-GLP pharmacologic weight-management therapy, but causal inference is precluded by residual confounding, uncertain treatment persistence, and possible misclassification. - Keywords highlighted: **GLP-1 receptor agonists**, **asthma**, **obesity**, tirzepatide.
## Clinical Analysis & Structured Key Points
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Online ahead of print. # Association of GLP-1-based therapy with asthma-related outcomes in patients with obesity: a propensity-matched retrospective cohort study [Cameron Dean McCraw](https://pubmed.ncbi.nlm.nih.gov/?term=McCraw+CD&cauthor_id=42733229)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#full-view-affiliation-1 "Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA."), [Dominique Rose Grayeb](https://pubmed.ncbi.nlm.nih.gov/?term=Grayeb+DR&cauthor_id=42733229)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#full-view-affiliation-1 "Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA."), [Navneet Gupta](https://pubmed.ncbi.nlm.nih.gov/?term=Gupta+N&cauthor_id=42733229)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#full-view-affiliation-2 "Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA, USA."), [Palwasha Zafar](https://pubmed.ncbi.nlm.nih.gov/?term=Zafar+P&cauthor_id=42733229)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#full-view-affiliation-2 "Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA, USA."), [Anam Javed](https://pubmed.ncbi.nlm.nih.gov/?term=Javed+A&cauthor_id=42733229)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#full-view-affiliation-2 "Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA, USA."), [Kainat](https://pubmed.ncbi.nlm.nih.gov/?term=Kainat&cauthor_id=42733229)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#full-view-affiliation-3 "Department of Internal Medicine, Fatima Jinnah Medical University, Lahore, Pakistan."), [Zayaan A Adrish](https://pubmed.ncbi.nlm.nih.gov/?term=Adrish+ZA&cauthor_id=42733229)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#full-view-affiliation-4 "Lawrence E Elkins High School, Missouri, TX, USA."), [Humza Saeed](https://pubmed.ncbi.nlm.nih.gov/?term=Saeed+H&cauthor_id=42733229)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#full-view-affiliation-5 "Department of Internal Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan."), [Abu Baker Sheikh](https://pubmed.ncbi.nlm.nih.gov/?term=Sheikh+AB&cauthor_id=42733229)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#full-view-affiliation-1 "Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA."), [Adeel Nasrullah](https://pubmed.ncbi.nlm.nih.gov/?term=Nasrullah+A&cauthor_id=42733229)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#full-view-affiliation-6 "Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA, USA.") Affiliations Expand ### Affiliations * 1 Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA. * 2 Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA, USA. * 3 Department of Internal Medicine, Fatima Jinnah Medical University, Lahore, Pakistan. * 4 Lawrence E Elkins High School, Missouri, TX, USA. * 5 Department of Internal Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan. * 6 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA, USA. * PMID: **42733229** * DOI: [ 10.1080/17476348.2026.2730537 ](https://doi.org/10.1080/17476348.2026.2730537) Item in Clipboard # Association of GLP-1-based therapy with asthma-related outcomes in patients with obesity: a propensity-matched retrospective cohort study Cameron Dean McCraw et al. Expert Rev Respir Med. 2026. Show details Display options Display options Format Abstract PubMed PMID Expert Rev Respir Med Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Expert+Rev+Respir+Med%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Expert+Rev+Respir+Med%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42733229/) . 2026 Sep 23:1-9. doi: 10.1080/17476348.2026.2730537. Online ahead of print. ### Authors [Cameron Dean McCraw](https://pubmed.ncbi.nlm.nih.gov/?term=McCraw+CD&cauthor_id=42733229)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#short-view-affiliation-1 "Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA."), [Dominique Rose Grayeb](https://pubmed.ncbi.nlm.nih.gov/?term=Grayeb+DR&cauthor_id=42733229)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#short-view-affiliation-1 "Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA."), [Navneet Gupta](https://pubmed.ncbi.nlm.nih.gov/?term=Gupta+N&cauthor_id=42733229)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#short-view-affiliation-2 "Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA, USA."), [Palwasha Zafar](https://pubmed.ncbi.nlm.nih.gov/?term=Zafar+P&cauthor_id=42733229)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#short-view-affiliation-2 "Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA, USA."), [Anam Javed](https://pubmed.ncbi.nlm.nih.gov/?term=Javed+A&cauthor_id=42733229)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#short-view-affiliation-2 "Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA, USA."), [Kainat](https://pubmed.ncbi.nlm.nih.gov/?term=Kainat&cauthor_id=42733229)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#short-view-affiliation-3 "Department of Internal Medicine, Fatima Jinnah Medical University, Lahore, Pakistan."), [Zayaan A Adrish](https://pubmed.ncbi.nlm.nih.gov/?term=Adrish+ZA&cauthor_id=42733229)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#short-view-affiliation-4 "Lawrence E Elkins High School, Missouri, TX, USA."), [Humza Saeed](https://pubmed.ncbi.nlm.nih.gov/?term=Saeed+H&cauthor_id=42733229)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#short-view-affiliation-5 "Department of Internal Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan."), [Abu Baker Sheikh](https://pubmed.ncbi.nlm.nih.gov/?term=Sheikh+AB&cauthor_id=42733229)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#short-view-affiliation-1 "Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA."), [Adeel Nasrullah](https://pubmed.ncbi.nlm.nih.gov/?term=Nasrullah+A&cauthor_id=42733229)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42733229/#short-view-affiliation-6 "Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA, USA.") ### Affiliations * 1 Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA. * 2 Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA, USA. * 3 Department of Internal Medicine, Fatima Jinnah Medical University, Lahore, Pakistan. * 4 Lawrence E Elkins High School, Missouri, TX, USA. * 5 Department of Internal Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan. * 6 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA, USA. * PMID: **42733229** * DOI: [ 10.1080/17476348.2026.2730537 ](https://doi.org/10.1080/17476348.2026.2730537) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Obesity worsens asthma morbidity, but observational associations between glucagon-like peptide-1 (GLP-1)-based therapy and respiratory outcomes may be confounded by treatment selection. **Research design and methods:** We conducted an active-comparator retrospective cohort study in the TriNetX US Collaborative Network across 72 healthcare organizations. Adults with body mass index (BMI) ≥30 kg/m2, repeated asthma documentation, and subsequent GLP-1-based therapy were compared with patients receiving active non-GLP pharmacologic weight-management therapy. After 1:1 propensity-score matching, 2,423 patients remained per cohort. Outcomes were assessed from day 1 through day 365 after the treatment-aligned index event. **Results:** Recorded asthma exacerbation occurred in 1.7% versus 4.0% (risk difference [RD], -2.2%; 95% confidence interval (CI), -3.2% to -1.3%; risk ratio [RR], 0.438; 95% CI, 0.306-0.626). GLP-1-based therapy was also associated with lower systemic glucocorticoid exposure (16.4% vs 23.1%; RR, 0.712), emergency department/critical-care utilization (7.1% vs 13.0%; RR, 0.541), and acute respiratory failure (0.7% vs 1.8%; RR, 0.364). BMI- and glycated hemoglobin (HbA1c)-restricted sensitivity analyses were generally directionally concordant. GLP-1-specific adverse events were not systematically assessed. **Conclusions:** GLP-1-based therapy was associated with fewer recorded one-year respiratory and utilization events than active non-GLP pharmacotherapy. Residual confounding, treatment-persistence uncertainty, and exposure/outcome misclassification preclude causal inference. **Keywords:** Asthma; GLP-1 receptor agonists; electronic health records; obesity; propensity-score matching; tirzepatide. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ GLP-1 receptor agonists and clinical outcomes in adults with Crohn's disease and obesity: a propensity score-matched real-world cohort study. ](https://pubmed.ncbi.nlm.nih.gov/42321339/) Ganju N, Ssebambulidde K, Gupta S, Adidam SR, Michael M, Kibreab A, Aduli F.Ganju N, et al.Sci Rep. 2026 Jun 19;16(1):28181. doi: 10.1038/s41598-026-58181-y.Sci Rep. 2026.PMID: 42321339Free PMC article. * [ Impact of GLP-1 Dose Intensity on Perioperative and Long-Term Fusion Outcomes Following ACDF. ](https://pubmed.ncbi.nlm.nih.gov/42705550/) Stirpe C, Lee B, Lavu M, Ding I, Furey C, Cheng CW.Stirpe C, et al.Spine J. 2026 Sep 7:S1529-9430(26)00640-6. doi: 10.1016/j.spinee.2026.08.009. 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Epub 2026 Jun 30.Diab Vasc Dis Res. 2026.PMID: 42376874Free PMC article. * [ Tirzepatide for adults living with obesity. ](https://pubmed.ncbi.nlm.nih.gov/41161687/) Franco JV, Guo Y, Varela LB, Aqra Z, Alhalahla M, Medina Rodriguez M, Salvador Oscco EL, Patiño Araujo B, Banda S, Escobar Liquitay CM, Bracchiglione J, Meza N, Madrid E.Franco JV, et al.Cochrane Database Syst Rev. 2025 Oct 30;10(10):CD016018. doi: 10.1002/14651858.CD016018.Cochrane Database Syst Rev. 2025.PMID: 41161687 [ See all similar articles ](https://pubmed.ncbi.nlm.nih.gov/?linkname=pubmed_pubmed&from_uid=42733229) ## Related information * [ MedGen ](https://www.ncbi.nlm.nih.gov/medgen?linkname=pubmed_medgen&from_uid=42733229 "Related information in MedGen") ## LinkOut - more resources * ### Full Text Sources * [ Atypon ](https://www.tandfonline.com/doi/10.1080/17476348.2026.2730537?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed) * ### Other Literature Sources * [ figshare - Access datasets and other research materials. ](https://figshare.com/articles/by-resource-doi/10.1080/17476348.2026.2730537) * ### Miscellaneous * [ NCI CPTAC Assay Portal ](https://assays.cancer.gov/CPTAC-999) **Full text links** [x] [![Atypon full text link](https://cdn.ncbi.nlm.nih.gov/corehtml/query/egifs/https:--www.tandfonline.com-pb-assets-tandf-logos-tf_pubmed_fulltext_icon.png) Atypon ](https://www.tandfonline.com/doi/10.1080/17476348.2026.2730537?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed "See full text options at Atypon") [x] Cite Copy Download .nbib .nbib Format: AMA APA MLA NLM **Send To** * [Clipboard](https://pubmed.ncbi.nlm.nih.gov/42733229/) * [Email](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42733229%2F%23open-email-panel) * [Save](https://pubmed.ncbi.nlm.nih.gov/42733229/) * [My Bibliography](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42733229%2F%23open-bibliography-panel) * [Collections](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42733229%2F%23open-collections-panel) * [Citation Manager](https://pubmed.ncbi.nlm.nih.gov/42733229/) [x] NCBI Literature Resources [MeSH](https://www.ncbi.nlm.nih.gov/mesh/) [PMC](https://www.ncbi.nlm.nih.gov/pmc/) [Bookshelf](https://www.ncbi.nlm.nih.gov/books) [Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 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