Hershey, PA—Commonly prescribed type 2 diabetes (T2D) drugs show promise for protecting against severe COVID-19, according to a new study.
Glucagon-like peptide-1 receptor (GLP-1R) agonists, which are prescribed to treat obesity and T2D were associated with a decreased risk of hospitalization, respiratory complications, and death in COVID-19 patients with T2D when taken 6 months prior to diagnosis. Penn State College of Medicine researchers gathered that information by analyzing electronic medical records of about 30,000 patients from 56 large healthcare organizations.
“Our results are very promising as GLP-1R agonist treatment appears to be highly protective, but more research is needed to establish a causal relationship between the use of these drugs and decreased risk for severe COVID-19 outcomes in patients with Type 2 diabetes,” said Patricia “Sue” Grigson, PhD, MS, professor and chair of the Department of Neural and Behavioral Sciences.
The article in Diabetes notes that T2D patients are at increased risk of severe COVID-19 outcomes and that dysregulated inflammatory responses are a suspected cause. “Glucose-regulating medications such as glucagon-like peptide-1 receptor (GLP-1R) agonists, dipeptidyl peptidase-4 (DPP-4) inhibitors, and pioglitazone are known to have anti-inflammatory effects that may improve outcomes in patients with SARS-CoV-2 infection,” the authors write.
The study team examined the medications related to the incidence of hospital admissions, respiratory complications, and mortality within 28 days following a COVID-19 diagnosis.
After matching for age, sex, race, ethnicity, body mass index, and significant comorbidities, the researchers determined that use of GLP-1R agonists and/or pioglitazone was associated with significant reductions in hospital admissions (GLP-1R: 15.7% vs. 23.5%; RR, 0.67 [95% CI, 0.57-0.79]; P <.001; pioglitazone: 20.0% vs. 28.2%; RR, 0.71 [95% CI, 0.54-0.93]; P =.01). Use of GLP-1R agonists was also associated with reductions in respiratory complications (15.3% vs. 24.9%; RR, 0.62 [95% CI, 0.52-0.73]; P <.001) and incidence of mortality (1.9% vs. 3.3%; RR, 0.58 [95% CI, 0.35-0.97]; P =.04), they add.
The report also notes that the use of DPP-4 inhibitors was associated with a reduction in respiratory complications (24.0% vs. 29.2%; RR, 0.82 [95% CI, 0.74-0.90]; P <.001). The researchers also note that continued use of DPP-4 inhibitors after hospitalization was associated with a decrease in mortality compared with those who discontinued use (9% vs. 19%; RR, 0.45 [95% CI, 0.28-0.72]; P <.001).
“Use of glucose-regulating medications such as GLP-1R agonists, DPP-4 inhibitors, or pioglitazone may improve outcomes for COVID-19 patients with T2DM; randomized clinical trials are needed to further investigate this possibility,” the authors conclude.
“Vaccines have been shown to reduce hospitalization and death from COVID-19,” said Jennifer Nyland, PhD, assistant professor of neural and behavioral sciences and co-author of the study. “But the scientific community continues to search for treatments that may complement vaccination by further reducing the risk of hospitalization, respiratory complications and death from COVID-19 in at-risk patients with pre-existing conditions like diabetes.”
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