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Mark Greener's second batch of studies this month includes new evidence on GLP-1 receptor agonists’ potential to reduce respiratory exacerbations and psychiatric hospitalisations, a UKHSA warning over rising autumn giardiasis cases, and reassuring South Korean data on inhaled corticosteroid use in early pregnancy.
Ross Ferguson,
21 Oct 20265 Min
In Evidence reviews
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GLP-1s cut respiratory attacks...
Glucagon-like peptide-1 receptor agonists (GLP1-RAs) can reduce the number of asthma and chronic obstructive pulmonary disease (COPD) exacerbations, according to research presented during the European Respiratory Society Congress in Barcelona.
“GLP-1 receptor agonists are widely used to treat type 2 diabetes and obesity. Previous research suggests that they may have anti-inflammatory effects and may improve lung-related outcomes. However, asthma and COPD … have not been included as outcomes in GLP-1 drug trials,” said Dr Chloe Bloom from the National Heart and Lung Institute, London, who led the study.
Researchers analysed the UK electronic medical records of 28,539 people with asthma or COPD. Of these, 8,266 started taking a GLP1-RA and 20,273 controls began sulfonylureas.
Semaglutide reduced the number of airway exacerbations by 30% compared with controls. Exenatide and dulaglutide reduced exacerbations by 23% and 12% respectively. Liraglutide and lixisenatide reduced airway exacerbations, but the declines were not statistically significant. Semaglutide reduced the number of exacerbations more in people with asthma than COPD: by 38% and 21% respectively.
“The findings from this study are encouraging, but they should not change treatment decisions on their own. People with asthma or COPD should not start GLP-1 receptor agonists specifically for their lung condition outside current prescribing guidance,” Bloom added.
“While the findings suggest that some people taking GLP-1 receptor agonists may experience fewer respiratory attacks, this needs confirmation in [further] clinical trials,” she concluded.
...Also bipolar hospitalisations and relapse
In people with bipolar disease, semaglutide reduces the risk of psychiatric hospitalisation and relapses, according to a within-patient analysis of Swedish medical records.
Researchers included 5,200 people with bipolar disease and diabetes and/or obesity who used GLP-1RAs. Participants’ mean age at baseline was 48.9 years and 68.0% were female.
During a mean follow-up of six years, semaglutide reduced the risk of psychiatric hospitalisations by 21% compared with when the patient was not using GLP-1RAs. Less substance misuse may account for some of the reduction.
However, semaglutide also reduced the likelihood of experiencing a relapse of bipolar disorder by 17%. Liraglutide and dulaglutide were not associated with a lower hospitalisation risk. However, fewer people took these GLP-1RAs, so these analyses lack statistical power. GLP-1RAs did not significantly influence sick leave from work for psychiatric reasons.
GLP-1RAs could directly affect brain function, such as reducing neuroinflammation, and being neuroprotective and neurotrophic.
“The findings add to growing evidence that GLP-1 receptor agonists may have benefits beyond diabetes and obesity treatment, and could represent a promising new avenue for bipolar research,” said Professor Mark Taylor, Griffith University, Australia, who led the study.
In 1681, Antonie van Leeuwenhoek scrutinised his faeces under a microscope and saw a pear-shaped single-cell parasite now called Giardia intestinalis. Last year, the number of giardiasis cases in England was the highest since 2016 and peaked during the autumn.
“Symptoms can last from weeks to several months and if left untreated, [giardiasis] can cause serious complications especially in young children, the elderly and those with weakened immune systems,” says Nicola Love, senior food safety surveillance lead, UK Health Security Agency (UKHSA).
G. intestinalis attaches to the intestinal wall and causes diarrhoea, which is often foul-smelling, and, typically, abdominal cramps, bloating, burping, wind and weight loss. In rare cases, untreated children infected with G. intestinalis experience significant weight loss, malnutrition and stunted growth.
The UKHSA say that the number of giardiasis cases in England rose from 5,450 in 2024 to 6,069 in 2025. London and the North West reported the most cases (1,568 and 1,029 respectively). The UKHSA is investigating the reasons for the rise, but more effective testing, increased travel since the Covid-19 pandemic, and climate and environmental changes may contribute.
Giardia, which can be acquired in the UK, spreads by direct (including sexual) contact with infected people, from animals or by swallowing contaminated food or water. The UKHSA recommends good hygiene and that international travellers should take precautions, such as drinking bottled water, avoiding raw food and being careful when open-water swimming.
Pharmacists can reassure pregnant women that using inhaled corticosteroids (ICS) during the first trimester does not increase the risk of poor maternal or neonatal outcomes, according to a study from South Korea.
Researchers analysed health records for 3,909,084 pregnancies. Of these, 6,105 women received at least two ICS prescriptions for asthma in the six months before their last menstrual period and 2,108 women continued using ICS during the first trimester.
Compared with women who discontinued ICS, continued ICS did not significantly affect the risk of: preeclampsia; gestational diabetes; preterm birth; low birth weight; or congenital malformations. Similarly, no difference emerged for obstructed labour; antepartum haemorrhage; premature membrane rupture; or neonatal hypoxia or asphyxia. The results were consistent when stratified for maternal age and history of asthma exacerbation.
Women with more severe asthma may have been particularly likely to continue ICS during pregnancy. So, the authors add, “the observed similarity in maternal and neonatal outcomes between continuers and discontinuers should be interpreted in the context of potential baseline severity differences, supporting the need for individualized asthma management during pregnancy while maintaining appropriate ICS therapy”.
Some previous studies found that reduced ICS use may contribute to asthma exacerbations and adverse obstetric outcomes. However, the new study supports “the continuation of ICS therapy during pregnancy when clinically indicated to maintain asthma control”. (JAMA Network Open 2026;9:e2630781)
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