Tirzepatide and Semaglutide Show Similar Asthma Exacerbation Risk

Tirzepatide and semaglutide were associated with a similar risk of asthma exacerbation among patients with asthma and type 2 diabetes in a US multicenter retrospective cohort study published in the Journal of Asthma and Allergy.

Investigators identified 455,196 patients with both conditions in electronic health records. The eligible treatment groups included 8,178 tirzepatide users and 28,135 semaglutide users. After propensity-score matching, 8,176 patients remained in each group, with balanced measured baseline characteristics and mean follow-up of approximately 1 year.

Asthma exacerbation risk did not differ between treatments in the primary analysis (hazard ratio, 1.00; 95% CI, 0.91-1.10). Results remained similar when follow-up was set at 6 months (hazard ratio, 0.99; 95% CI, 0.88-1.11) or 18 months (hazard ratio, 0.98; 95% CI, 0.91-1.06). Subgroup analyses in patients with heart failure or chronic kidney disease likewise did not identify a difference.

The authors noted that previously reported advantages of tirzepatide for weight reduction and glycemic control did not translate into a lower observed exacerbation risk in this cohort. The study assessed association rather than causation, and limitations included possible residual confounding, reliance on prescription records, treatment switching or discontinuation, outcome misclassification, and selection bias related to excluding patients with missing body mass index or hemoglobin A1c data.

The investigators concluded that asthma exacerbation risk was comparable between the two therapies in this population. Randomized controlled trials are needed to clarify the comparative effects of tirzepatide and semaglutide on asthma outcomes.

Source: Hung CT, An CY, Suk CW, et al. Association of tirzepatide versus semaglutide with risk of asthma exacerbation in patients with asthma and type 2 diabetes: a US multicenter retrospective cohort study. J Asthma Allergy. Published online September 7, 2026. doi.org/10.2147/JAA.S637738