# Do GLP-1 Drugs Help COPD? Fewer Flare-Ups, Against One Comparator | This GLP Do GLP-1 drugs help COPD? 32,107 matched pairs, 9.89 exacerbations per 100 person-years against 11.49, and the head-to-head comparison that finds almost nothing. Publisher: This GLP Editorial Team Canonical: https://thisglp.com/research/do-glp1-drugs-help-copd Updated: 2026-09-17 Published: 2026-09-16 [← Research](https://thisglp.com/research) Evidence # Do GLP-1 Drugs Help COPD? Fewer Flare-Ups, Against One Comparator Against an older drug class, GLP-1 use came with fewer exacerbations. Against SGLT2 inhibitors the hazard ratio was 0.94, with an interval reaching 1.00. [This GLP Editorial Team](https://thisglp.com/about)September 20268 min readUpdated September 2026 Exacerbations per 100 person-years · GLP-1 · 9.89 · DPP-4 · 11.49 · SGLT2 · 9.26 · DPP-4 · 11.4 · SGLT2 · 9.47 · GLP-1 · 10 · The third pair is the head-to-head, and it is nearly a tie. **Research, not medical advice.** This GLP is independent and educational. Nothing here is a substitute for individualized care from a licensed clinician, and reading it creates no doctor–patient relationship. Talk to your own provider before starting, stopping, or changing any medication, peptide, or therapy. See our [methodology](https://thisglp.com/methodology) and [terms](https://thisglp.com/terms). Against an older diabetes drug class, yes, and against the other new class, barely. In 32,107 matched pairs of adults with type 2 diabetes and COPD, GLP-1 users had 9.89 moderate or severe exacerbations per 100 person-years against 11.49 on DPP-4 inhibitors [\[1\]](https://thisglp.com/research/do-glp1-drugs-help-copd#ref-1). That is a hazard ratio of 0.86 (95% CI 0.81 to 0.91). Put against SGLT2 inhibitors instead, the hazard ratio was 0.94 with an interval running to 1.00, which touches no effect. Everyone in the study had diabetes and coded COPD at a mean age near 70, which is not the population buying from [a telehealth page](https://thisglp.com/research/what-glp1-sellers-do-not-publish). ## Key takeaways - In 32,107 matched pairs, GLP-1 users had 9.89 COPD exacerbations per 100 person-years against 11.49 on DPP-4 inhibitors — a hazard ratio of 0.86 (95% CI 0.81 to 0.91). - SGLT2 inhibitors against the same comparator ran 9.26 against 11.4, a hazard ratio of 0.81 (95% CI 0.76 to 0.86) across 27,991 pairs. - Head to head, the two newer classes were 9.47 against 10.00 per 100 person-years — a hazard ratio of 0.94 whose interval reaches 1.00. - Mean age was near 70, every patient had type 2 diabetes and coded COPD, and median follow-up was 145 days. - A separate systematic review of 123 studies found no increase in respiratory adverse events on these drugs against placebo. - In asthma, a matched cohort recorded exacerbations in 1.7% against 4.0% — a ratio of 0.438 and a difference of 2.2 points. ## Two comparisons that favor the newer drugs The study emulated three target trials in US insurance claims, matching patients aged 40 and over who carried both diagnoses [\[1\]](https://thisglp.com/research/do-glp1-drugs-help-copd#ref-1). Against DPP-4 inhibitors, GLP-1 receptor agonists came in at 9.89 exacerbations per 100 person-years against 11.49 across 32,107 matched pairs. SGLT2 inhibitors against the same comparator ran 9.26 against 11.4, a hazard ratio of 0.81 (95% CI 0.76 to 0.86) across 27,991 pairs. Both results held across the sensitivity and subgroup analyses the authors report. ## And one that finds almost nothing The third comparison put the two newer classes against each other in 36,218 matched pairs, and the difference nearly vanished. It was 9.47 against 10.00 per 100 person-years, a hazard ratio of 0.94 with a 95% confidence interval of 0.89 to 1.00. The upper bound touches no effect, and the rate difference says the same thing at −0.55 per 100 person-years with an interval running to −0.01. Both classes beat an older one and neither clearly beats the other. Quoting the first two comparisons alone would imply a ranking this study does not support, which is the shape taken apart in [two meta-analyses of the same six trials](https://thisglp.com/research/glp1-two-meta-analyses-same-six-trials). ## Do these drugs harm breathing in the first place That is a separate question and it has its own answer. A systematic review screened 9,086 records and included 123 studies of respiratory adverse events on weight-loss drugs [\[2\]](https://thisglp.com/research/do-glp1-drugs-help-copd#ref-2). Liraglutide, semaglutide, tirzepatide and naltrexone-bupropion showed no increase against placebo, with the contributing randomized trials at low risk of bias. Of those 123 studies, 122 were in general populations and one was in people with asthma, so the reassurance mostly comes from people without a lung condition. The full reading of that gap is in [the respiratory safety review](https://thisglp.com/research/one-asthma-study-in-a-hundred-and-twenty-three). ## The nearest efficacy result in another lung disease Asthma has been measured with a tighter design. A propensity-matched cohort of 2,423 adults per group recorded an asthma exacerbation in 1.7% against 4.0% over the following year, a ratio of 0.438 (95% CI 0.306 to 0.626) [\[3\]](https://thisglp.com/research/do-glp1-drugs-help-copd#ref-3). Stated as a difference that is 2.2 percentage points, and the difference is the number that tells a reader what it might mean for them. Systemic glucocorticoid exposure ran 16.4% against 23.1%. COPD and asthma are different diseases, so this is a neighbor rather than a substitute. The same gap between a ratio and a difference is set out in [the asthma cohort](https://thisglp.com/research/glp1-asthma-relative-and-absolute). ## Who was in it, and who was not The cohorts were old and sick by the standards of this market: a mean age near 70, type 2 diabetes, and COPD active enough to be coded as such. Median follow-up was 145 days, with an interquartile range of 61 to 355, which is short for a chronic lung condition. A person buying compounded semaglutide from a telehealth page at 45 with no lung disease sits outside the population these numbers describe. Nothing here is a reason to choose one seller over another. It is a reason to make sure whoever writes the prescription knows the rest of the history. That gap is counted in [what happens outside a trial](https://thisglp.com/research/glp1-weight-loss-in-ordinary-care) and put into [questions they leave open](https://thisglp.com/tools/questions-they-leave-open). ## Frequently asked Do GLP-1 drugs cause breathing problems? A systematic review of 123 studies found no increase in respiratory adverse events for liraglutide, semaglutide, tirzepatide or naltrexone-bupropion against placebo. Only one of the 123 studies was in people with a lung condition. Do GLP-1 drugs reduce COPD flare-ups? Against DPP-4 inhibitors, yes — 9.89 against 11.49 per 100 person-years, a hazard ratio of 0.86. Against SGLT2 inhibitors the difference was 0.94 with an interval reaching 1.00, which is close to nothing. Does this apply to me if I do not have diabetes? No. Every cohort required type 2 diabetes and active COPD, at a mean age near 70. That is not the population buying these drugs from a telehealth page. How long were people followed? A median of 145 days, with an interquartile range of 61 to 355 — short for a chronic lung condition. ## Sources 1. \[1\] Ray A, et al. (2025). Glucose-Lowering Medications and Risk of Chronic Obstructive Pulmonary Disease Exacerbations in Patients With Type 2 Diabetes JAMA Internal Medicine. [PMID 39928303](https://pubmed.ncbi.nlm.nih.gov/39928303/) 2. \[2\] Zeng L, Zinmon-Htet C, Hundie T, Lin S, et al. (2026). Respiratory Adverse Events of Weight-Loss Drugs: A Systematic Review and Meta-Analysis Annals of the American Thoracic Society. [PMID 42479131](https://pubmed.ncbi.nlm.nih.gov/42479131/) 3. \[3\] McCraw C, Grayeb D, Gupta N, Zafar P, et al. (2026). Association of GLP-1-based therapy with asthma-related outcomes in patients with obesity: a propensity-matched retrospective cohort study Expert Review of Respiratory Medicine. [PMID 42733229](https://pubmed.ncbi.nlm.nih.gov/42733229/) ## Where to get it ### Best GLP-1 injections Every injectable seller we can verify, with the price each one publishes and an honest read of what the trials measured. [Compare providers →](https://thisglp.com/best/compounded-semaglutide) ## More in Evidence - [ 150 minutes · Weekly activity goal · 2 days · Muscle strengthening · Adapt · Symptoms and ability ### Exercise on Ozempic: Building Strength Without Ignoring Symptoms ](https://thisglp.com/research/exercise-on-ozempic) - [ STEP 1, semaglutide 2.4 mg vs placebo, % change at 68 weeks · LDL cholesterol · −2.5% vs +1.3% · Total cholesterol · −3.3% vs +0.1% · HDL cholesterol · +5.2% vs +1.4% · Triglycerides · −21.9% vs −7.3% · Wegovy label, Table 13. Adults without diabetes. Ozempic doses are lower. ### Does Ozempic Lower Cholesterol? 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