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GLP1RA 类药物的使用与呼吸障碍的发生:GLP1RA 大型随机试验的荟萃分析。

Use of GLP1RAs and occurrence of respiratory disorders: A meta-analysis of large randomized trials of GLP1RAs.

机构信息

Department of Pulmonary and Critical Care Medicine, PanZhiHua Central Hospital, PanZhiHua, China.

Department of Endocrinology, First Affiliated Hospital of Yangtze University, JingZhou, China.

出版信息

Clin Respir J. 2021 Jul;15(7):847-850. doi: 10.1111/crj.13372. Epub 2021 Apr 19.

Abstract

OBJECTIVES

No large sample studies have been designed to evaluate the efficacy of glucagon-like peptide-1 receptor agonists (GLP1RAs) in the primary and secondary prevention of respiratory disorders. We aimed at evaluating the relationship between use of GLP1RAs and occurrence of 12 kinds of respiratory disorders.

METHODS

Large randomized placebo-controlled trials of GLP1RAs were included. We conducted meta-analysis using random effects model and measured heterogeneity using I . Treatment effect was presented as risk ratio (RR) and 95% confidence interval (CI).

RESULTS

Seven trials including 55 922 participants were included in meta-analysis. The occurrence rates of various respiratory disorders were low, with the minimum of 0.02% (pulmonary fibrosis) and the maximum of 2.31% (pneumonia). Although not reaching statistical significance, GLP1RAs versus placebo showed the reduced trends in the risks of nine kinds of respiratory disorders including pneumonia (RR 0.89, 95% CI 0.78-1.01), squamous cell carcinoma of lung (SCCL; RR 0.55, 95% CI 0.25-1.21), asthma (RR 0.82, 95% CI 0.51-1.32), and chronic obstructive pulmonary disease (COPD; RR 0.89, 95% CI 0.73-1.10), but the increased trend in interstitial lung disease (ILD; RR 1.89, 95% CI 0.87-4.08). GLP1RAs had neutral effects on two other respiratory disorders. Heterogeneity in any meta-analysis was absent or low.

CONCLUSION

GLP1RAs show the reduced trends in the risks of nine kinds of respiratory disorders (eg, pneumonia, SCCL, asthma, and COPD), but the increased trend in the risk of ILD. However, these findings need to be validated by further studies due to the low incidence rates of all the respiratory disorders.

摘要

目的

目前尚无大规模样本研究评估胰高血糖素样肽-1 受体激动剂(GLP1RAs)在呼吸系统疾病一级和二级预防中的疗效。本研究旨在评估 GLP1RA 使用与 12 种呼吸系统疾病发生之间的关系。

方法

纳入 GLP1RA 的大型随机安慰剂对照试验。我们采用随机效应模型进行荟萃分析,并用 I² 衡量异质性。治疗效果表示为风险比(RR)和 95%置信区间(CI)。

结果

纳入 7 项包含 55922 名参与者的试验进行荟萃分析。各种呼吸系统疾病的发生率较低,最低为 0.02%(肺纤维化),最高为 2.31%(肺炎)。虽然未达到统计学意义,但 GLP1RA 与安慰剂相比,9 种呼吸系统疾病(肺炎 RR 0.89,95%CI 0.78-1.01;鳞状细胞肺癌 RR 0.55,95%CI 0.25-1.21;哮喘 RR 0.82,95%CI 0.51-1.32;慢性阻塞性肺疾病 RR 0.89,95%CI 0.73-1.10)的风险呈下降趋势,但间质性肺病 RR 1.89,95%CI 0.87-4.08)的风险呈上升趋势。GLP1RA 对其他两种呼吸系统疾病无明显影响。任何荟萃分析的异质性均不存在或较低。

结论

GLP1RA 降低了 9 种呼吸系统疾病(如肺炎、鳞状细胞肺癌、哮喘和慢性阻塞性肺疾病)的发病风险,但增加了间质性肺病的风险。然而,由于所有呼吸系统疾病的发病率都较低,这些发现还需要进一步的研究来验证。

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