S102 The potential effect of glucagon-like peptide 1 receptor agonists (GLP1s) on chronic obstructive pulmonary disease (COPD) exacerbations, a case control analyses
Bibliographic record
Abstract
Introduction Reducing the risk of exacerbations is a key objective of COPD management. Recently published studies have demonstrated that GLP-1RAs used for weight loss also have benefits on respiratory outcomes within asthma.1 Aims The aim of this study was to use real-world data from the Optimum Patient Care Research Database (OPCRD) to determine whether respiratory benefits might extend to a COPD population & Type 2 Diabetes. Methods Our exposed cohort were prescribed a GLP-1RA, and had a diagnosis of COPD, type 2 diabetes, were over 40 years old at the time of the first GLP-1RA (index date). We identified an age, sex, smoking status and BMI matched control cohort of patients with COPD and diabetes who were contributing data to OPCRD at the time of their matched patients index date, their COPD treatments and number of exacerbations in the year prior to the GLP-1RA prescription. Exacerbation outcomes included a) specific exacerbation measure (chest infection type diagnosis with an antibiotic or steroid prescription), b) sensitive exacerbation measure (antibiotic or steroid prescription without a chest infection type diagnosis), c) OCS prescriptions and d) hospital admissions in the year following GLP1 initiation. Results The cases mean age was 66, 58% were male, the mean BMI was 36.25. Cases GOLD (2023) group classification were 16% A, 55% B, and 29% E. Controls were comparable. Patients receiving a GLP-1RAs had significantly lower risk of exacerbations (specific IRR 0.84: 0.79–0.89 p<0.001, sensitive IRR 0.89: 0.84–0.95 p=0.003). Cases had lower OCS prescriptions (IRR 0.86: 0.77–0.95 p<0.001) and respiratory hospitalisations (IRR 0.61: 0.41–0.74 p<0.001) compared with controls. Conclusions This real-world study provides evidence that GLP-1RAs therapy maybe associated with a lower risk of COPD exacerbations in patients with comorbid T2D suggesting a potential protective effect of GLP-1 RAs on respiratory health. Furthermore, an approximately 20% lower risk in exacerbations and corticosteroid prescriptions, is clinically meaningful, especially in a population with high multimorbidity burden. Large scale randomised trials are now needed to test this potential. Reference Kaplan A, Heatley H, Townend J, et al. The real-world impact of glucagon-like peptide 1 receptor agonists on asthma control in people with high-risk asthma and obesity. Adv Ther. 2025.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.012 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".