{
  "abstract": "Background: Chronic obstructive pulmonary disease (COPD) and type 2 diabetes (T2D) frequently coexist, sharing inflammatory and metabolic pathways. Tirzepatide (TZP), a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, has demonstrated metabolic and anti-inflammatory effects. However, its impact on pulmonary outcomes in patients with COPD and T2D remains uncertain.\n\nMethods: Using the TriNetX global research network, we conducted a retrospective cohort study of adults with coexisting COPD and T2D prescribed TZP, sodium-glucose cotransporter-2 inhibitors (SGLT2i), dipeptidyl peptidase-4 inhibitors (DPP-4i), or glucagon-like peptide-1 receptor agonists (GLP-1RA). Propensity score matching (1:1) was performed separately for each comparison. Primary outcome was COPD exacerbation; secondary outcomes included all-cause mortality, acute respiratory failure, and lower respiratory tract infection. Outcomes were assessed during a prespecified observation period from day one through day 365 after the index date.\n\nResults: Matched populations included 6,080 patients per group (TZP–SGLT2i), 4,684 (TZP–DPP-4i), and 6,727 (TZP–GLP-1RA). In the independently matched comparisons, median follow-up was 232 versus 365 days for TZP versus SGLT2i, 235 versus 365 days for TZP versus DPP-4i, and 233 versus 365 days for TZP versus other GLP-1RAs; incidence rates were expressed per 1,000 person-years. Compared with SGLT2i and DPP-4i, TZP significantly reduced COPD exacerbation risk (hazard ratio [HR] 0.73 [95% CI 0.64–0.82] and 0.72 [95% CI 0.63–0.82], respectively) and all-cause mortality (HR 0.30 [95% CI 0.23–0.38] and 0.24 [95% CI 0.18–0.31], respectively). TZP also reduced acute respiratory failure and lower respiratory tract infection risks. Outcomes were similar between TZP and GLP-1RA, except TZP showed lower mortality (HR 0.55 [95% CI 0.42–0.72]).\n\nConclusion: Among patients with COPD and T2D, TZP use was associated with lower risks of COPD exacerbations, respiratory complications, and mortality compared with SGLT2i and DPP-4i, findings that warrant confirmation through randomized clinical trials.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Internal Medicine, Chi Mei Medical Center , ,",
    "Department of General Medicine, Chi Mei Medical Center , ,",
    "Department of Nutrition, Chi Mei Medical Center , ,",
    "Department of Intensive Care Medicine, Chi Mei Medical Center , ,"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Wan-Hsuan Hsu"
    },
    {
      "affs": [
        1
      ],
      "name": "Yang-En Chan"
    },
    {
      "affs": [
        2
      ],
      "name": "Jheng-Yan Wu"
    },
    {
      "affs": [
        1
      ],
      "name": "Yao-Ming Chuang"
    },
    {
      "affs": [
        1
      ],
      "name": "Chia-Yu Kuo"
    },
    {
      "affs": [
        0
      ],
      "name": "Bo-Wen Shiau"
    },
    {
      "affs": [
        0
      ],
      "name": "Po-Yu Huang"
    },
    {
      "affs": [
        3
      ],
      "name": "Chih-Cheng Lai"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9274np6pbxgf3.bib",
  "cited_by": 0,
  "doi": "10.3389/fphar.2026.1917340",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690786/?tool=EBI",
  "id": "9274np6pbxgf3",
  "issns": [
    "1663-9812"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13690786",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Chronic Obstructive Pulmonary Disease (COPD) Research"
    ]
  ],
  "openalex": "W7221075034",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690786/pdf/?tool=EBI",
  "pmcid": "PMC13690786",
  "pmid": null,
  "published": "2026-10-09",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/9274np6pbxgf3.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:59Z",
      "native_id": "PMC:PMC13690786",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13690786"
    },
    {
      "first_seen": "2026-10-30T12:20:06Z",
      "native_id": "10.3389/fphar.2026.1917340",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1917340/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:1663-9812",
      "subfield": "pharmacology-toxicology"
    }
  ],
  "title": "Tirzepatide versus other glucose-lowering therapies and risk of COPD exacerbations in patients with comorbid type 2 diabetes: a retrospective cohort study",
  "title_text": "Tirzepatide versus other glucose-lowering therapies and risk of COPD exacerbations in patients with comorbid type 2 diabetes: a retrospective cohort study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:06Z",
  "url": "https://research.draconitic.com/paper/9274np6pbxgf3",
  "venue": "Frontiers in pharmacology",
  "versions": []
}