{
  "abstract": "Background: Sepsis is a major cause of morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD). Antihyperglycemic agents may influence infection risk through distinct immunometabolic pathways. We compared glucagon-like peptide-1 receptor agonists (GLP-1RAs) with dipeptidyl peptidase-4 inhibitors (DPP-4is) in patients with COPD and type 2 diabetes mellitus (T2DM).\n\nMethods: This population-based, active-comparator, new-user cohort study used the TriNetX Global Network. Adults aged 40–100 years with COPD and T2DM who initiated a GLP-1RA or DPP-4i between 2007 and 2019 were included. Propensity score matching (1:1) adjusted for demographics, BMI, HbA1c, COPD severity proxies, comorbidities, and medications. The primary outcome was sepsis; secondary outcomes were pneumonia, severe sepsis, and all-cause mortality, assessed at 1, 3, 6, 12, and 24 months.\n\nResults: Before matching, 21,622 patients started a GLP-1RA and 67,259 a DPP-4i; after matching, 20,074 remained in each group with balanced characteristics (all standardized mean differences <0.10). Compared with DPP-4i users, GLP-1RA users had a significantly lower risk of sepsis at 1 year (hazard ratio [HR] 0.852; 95% confidence interval [CI] 0.770–0.942). The risks of secondary outcomes at 1 year were numerically lower in the GLP-1RA group, with statistically significant reductions in pneumonia (HR 0.729; 95% CI 0.671–0.792) and all-cause mortality (HR 0.656; 95% CI 0.587–0.732), while the association with severe sepsis did not reach statistical significance (HR 0.891; 95% CI 0.770–1.033).\n\nConclusion: In patients with COPD and T2DM, initiation of GLP-1RAs was associated with lower risks of sepsis, pneumonia, and all-cause mortality compared with DPP-4is. However, given the observational design, causality cannot be established and residual confounding remains a potential limitation. While these findings suggest potential benefits of GLP-1RAs beyond glycemic control, further confirmation through randomized controlled trials is warranted to guide clinical decision-making.",
  "abstract_shown": true,
  "affiliations": [
    "School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan",
    "Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Taitung MacKay Memorial Hospital, Taitung, Taiwan",
    "Department of Medicine, MacKay Medical University, New Taipei City, Taiwan",
    "World Wise Executive Leadership Program, Minerva University, San Francisco, CA, USA",
    "Division of Pulmonary Medicine, Department of Internal Medicine, Cardinal Tien Hospital, and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan",
    "Medical Research Center, Cardinal Tien Hospital, and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan",
    "Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan",
    "School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ting-Jia Wu"
    },
    {
      "affs": [
        1,
        2,
        3
      ],
      "name": "Chao-Hsien Chen",
      "orcid": "0000-0002-2176-3504"
    },
    {
      "affs": [
        4
      ],
      "name": "Hsiu-Chin Wu"
    },
    {
      "affs": [
        5
      ],
      "name": "Ya-Hui Wang"
    },
    {
      "affs": [
        4
      ],
      "name": "Cheng-Yi Wang",
      "orcid": "0000-0001-7426-0743"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "Chih-Cheng Lai",
      "orcid": "0000-0002-6334-2388"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/enqamk9fnsakm.bib",
  "cited_by": 0,
  "doi": "10.2147/copd.s602087",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13729757/",
  "id": "enqamk9fnsakm",
  "issns": [
    "1176-9106",
    "1178-2005"
  ],
  "landing_url": "https://doi.org/10.2147/copd.s602087",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2712|Diabetes Treatment and Management"
    ]
  ],
  "openalex": "W7224499261",
  "pdf_url": "https://www.dovepress.com/article/download/121544",
  "pmcid": "PMC13729757",
  "pmid": "42979119",
  "published": "2026-10-30",
  "publisher": "Dove Press",
  "ris": "https://research.draconitic.com/paper/enqamk9fnsakm.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:22:30Z",
      "native_id": "PMC13729757",
      "source": "pmc",
      "url": "https://doi.org/10.2147/copd.s602087"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Diabetes Treatment and Management",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Comparative Effects of GLP-1 Receptor Agonists and DPP-4 Inhibitors on Sepsis in Patients with Chronic Obstructive Pulmonary Disease: A Population-Based Cohort Study",
  "title_text": "Comparative Effects of GLP-1 Receptor Agonists and DPP-4 Inhibitors on Sepsis in Patients with Chronic Obstructive Pulmonary Disease: A Population-Based Cohort Study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:22:30Z",
  "url": "https://research.draconitic.com/paper/enqamk9fnsakm",
  "venue": "International Journal of Chronic Obstructive Pulmonary Disease",
  "versions": []
}