USE OF glucagon-like peptide-1 receptor agonists (GLP-1RAs) is associated with a significantly lower risk of acute asthma exacerbations in adolescents with overweight or obesity, according to a large retrospective cohort study.
Obesity, Asthma, and an Unmet Clinical Need
Obesity is a well-established risk factor for poorer asthma control, increased symptom burden, and more frequent exacerbations in adolescents. As GLP-1RAs are increasingly prescribed for weight management in this age group, their potential effects on asthma outcomes have become an important clinical question. While adult studies have suggested possible respiratory benefits, findings have been inconsistent, and evidence in adolescents has been lacking.
Study Design and Key Findings
Researchers conducted a retrospective cohort study using data from the TriNetX global federated health research network between 2020 and 2025. The study included adolescents aged 12 to 18 years with diagnoses of asthma and overweight or obesity, with or without diabetes.
After 1:1 propensity score matching, 1,070 adolescents were included, with 535 receiving a new GLP-1RA prescription and 535 receiving nonpharmacological weight management interventions. Groups were well balanced for demographic characteristics, BMI categories, asthma severity proxies, and prior medication use.
During 12 months of follow-up, adolescents treated with GLP-1RAs experienced significantly fewer acute asthma exacerbations than controls (5.4% vs 10.7%), corresponding to a relative risk reduction of approximately 49%. GLP-1RA use was also associated with lower rates of asthma-related emergency department visits, systemic corticosteroid prescriptions, and short-acting beta-agonist use.
Among adolescents who experienced at least one exacerbation, the number of subsequent events over the follow-up period did not differ significantly between groups.
Possible Mechanisms and Clinical Implications
The findings suggest a potential dual benefit of GLP-1RAs in adolescents with obesity-related asthma, addressing both weight management and asthma exacerbation risk. Whether the observed association reflects weight loss, weight-independent anti-inflammatory effects, or metabolic improvements remains unclear.
Limitations and Future Research
As an observational study, the findings cannot establish causality and may be affected by residual confounding. The reliance on a predominantly US-based database may also limit generalisability. Nevertheless, this study is the first to demonstrate an association between GLP-1RA use and reduced asthma exacerbation risk in adolescents. Prospective randomised clinical trials are needed to confirm efficacy, clarify mechanisms, and assess safety before GLP-1RAs can be considered as adjunct therapy for asthma in this population.
Reference
Huang Y et al. Glucagonlike peptide-1 receptor agonists and asthma risk in adolescents with obesity. JAMA Netw Open. 2025;8(12):e2551611
