Tirzepatide and semaglutide were associated with similar asthma flare-up risk among adults with asthma and type 2 diabetes, according to a study published in the Journal of Asthma and Allergy. The retrospective cohort analysis used electronic health record data from the TriNetX US Collaborative Network to compare the two drugs. Researchers included patients older than 18 years with both asthma and a T2D diagnosis who used either medication between June 2022 and December 2024. The TriNetX network includes more than 65 healthcare organizations across the United States, providing a broad dataset for this analysis.
Comparing the Drugs
Among 455,196 patients with asthma and T2D, 8,178 received tirzepatide and 28,135 received semaglutide. After propensity score matching, the groups consisted of 8,176 patients each. The primary outcome was the time to the first asthma flare-up during a 12-month follow-up. The results showed that asthma flare-ups occurred in 11% of patients on tirzepatide and 11.1% of those on semaglutide. This similarity held true even when the follow-up period was shortened to six months or extended to 18 months. Data regarding systemic corticosteroid use remained consistent between the two treatment groups throughout the duration of the observation.
Despite the comparable risk of flare-ups, tirzepatide was associated with an 8% lower risk for short-acting beta-agonist use, with a hazard ratio of 0.92 (95% CI, 0.88 to 0.96). However, systemic corticosteroid use remained similar between the two groups. The secondary outcomes also measured time to first use of systemic corticosteroids, which did not differ significantly between the cohorts.
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Why Obesity Matters
Asthma and type 2 diabetes often coexist, affecting about 13% to 16% of patients with both conditions. Khalilah Gates, MD, a pulmonary and critical care specialist at the Northwestern Medicine Canning Thoracic Institute, explained that patients with obesity and asthma face unique challenges. Extra weight around the lungs can compromise airway openness and make it harder to expand the lungs. There is also a metabolic component where adipose tissue releases hormones and signaling molecules that cause inflammation and worsen airway inflammation.
The Need for More Data
Mark Moss, MD, director of the Clinical Research Program in the Division of Allergy and Immunology at the University of Wisconsin Hospitals, pointed out that preliminary studies suggest GLP-1 medications may benefit asthma control. Nevertheless, he stressed the need for well-designed, randomized clinical trials before any firm recommendations can be made regarding their specific use for asthma. Data supporting the potential respiratory effects of GLP-1-based therapies have grown in recent years, with several studies reporting better asthma outcomes among patients using these medications.
Disclosures: Drs. Gates and Moss reported no conflicts of interest. The study authors reported no conflicts of interest. All patients were followed until December 2025. The study authors reported no conflicts of interest.© 2026 HealthCentral LLC.