A study published in the Journal of Asthma and Allergy compared the effects of tirzepatide and semaglutide on asthma exacerbation risk in patients with type 2 diabetes (T2D). The research focused on adults over 18 years old diagnosed with both conditions who were treated with either medication between June 2022 and December 2024, with follow-up extending until December 2025.
Both drugs are GLP-1 receptor agonists, a class of medications initially designed for weight loss and glycemic control. The study found that while both drugs had similar asthma flare-up risks, tirzepatide was associated with lower short-acting beta-agonist (SABA) use. Specifically, tirzepatide users had an 8% lower risk of SABA use compared to semaglutide users, though systemic corticosteroid use remained unchanged between groups.
Asthma and T2D: A Common Co-Occurrence
The study highlights the prevalence of asthma and T2D co-occurrence, with 13-16% of patients affected by both conditions. This combination often leads to poorer asthma control, more severe exacerbations, and increased healthcare utilization. The overlap is particularly significant because both conditions share risk factors, such as obesity, which complicates management and outcomes.
Obesity, a common factor in T2D, can worsen asthma severity due to mechanical and metabolic factors. Extra weight around the lungs can compromise airway openness, while adipose tissue releases inflammatory molecules that may exacerbate asthma. Additionally, obesity can reduce the effectiveness of standard asthma therapies, further complicating treatment.
GLP-1 Therapies and Respiratory Effects
Recent research suggests GLP-1 therapies may have beneficial effects on respiratory health. Studies have shown associations between GLP-1 use and reduced asthma exacerbation risk, fewer emergency department visits, and lower hospitalization rates in patients with asthma and obstructive sleep apnea. For instance, a retrospective cohort study found GLP-1s were linked to a lower risk of asthma exacerbations compared to SGLT2 inhibitors, while another study highlighted improved outcomes in patients with both asthma and obstructive sleep apnea.
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Study Design and Findings
The study analyzed electronic health records from over 65 healthcare organizations in the US, involving 455,196 patients with both asthma and T2D. Among them, 8,178 received tirzepatide and 28,135 received semaglutide. The primary outcome was the time to the first asthma flare-up during a 12-month follow-up period, with secondary outcomes including the use of systemic corticosteroids and SABAs.
After propensity score matching, the analysis focused on 8,176 patients in each group. Asthma flare-ups occurred in 11% of patients on tirzepatide and 11.1% on semaglutide, with similar rates at 6-month (7.2% for both) and 18-month (13% tirzepatide, 13.6% semaglutide) follow-ups. The consistency across different follow-up periods reinforced the similarity in asthma flare-up risk between the two medications.
However, corticosteroid use remained similar between the groups, suggesting that tirzepatide’s benefits may be more specific to reducing rescue inhaler reliance rather than overall asthma control.
The study authors reported no conflicts of interest.© 2026 HealthCentral LLC.
