Impact of glucagon-like-peptide-1 receptor agonist therapy on pulmonary function in people with cystic fibrosis who achieve normal body mass index.

BACKGROUND

Glucagon-like-peptide-1 receptor agonists (GLP-1 RA) and glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 receptor agonists (GIP/GLP-1 RA) are being explored for use in people with CF (pwCF) and CF-related diabetes. In pwCF who are overweight or obese, GLP-1 RA and GIP/GLP-1 RA may offer additional benefits beyond glycemic control, including potential benefits in lung function. However, there is a paucity of evidence regarding the impact of these medications on pulmonary function in pwCF and whether the associated weight loss adversely affects lung function.

METHODS

This study is the first to describe the impact of GLP-1 RA and GIP/GLP-1 RA on lung function in pwCF who experienced weight loss and had a normal-range body mass index (BMI) of 18.5-24.9 kg/m2. Our cohort consists of 13 pwCF (12 females, 1 male; aged 23-46 years) treated with GLP-1 RA or GIP/GLP-1 RA for a median duration of 16 months (range 3-50 months).

RESULTS

Subjects experienced 11.1 kg median weight loss (-15.5 % median weight reduction); median BMI reduced from 26.2 kg/m2 to 21.7 kg/m2. Eleven of thirteen subjects had an increase in FEV1 (median, 10.8 %) and all subjects had an increase in FVC (median, 10.6 %). There was no difference in median number of pulmonary exacerbations between groups.

CONCLUSIONS

Future multi-center studies are needed to investigate the efficacy and tolerability of GLP-1 RA therapy in pwCF. If these agents are shown to be safe and effective in pwCF with normal-range BMI, then current BMI targets in pwCF may need to be revisited.