HMN 2025: How GLP-1 receptor agonist use linked to chronic cough among adults with type 2 diabetes

For patients with type 2 diabetes, there is an association between glucagon-like peptide-1 receptor agonist (GLP-1 RA) use and chronic cough, according to a study published online Nov. 26 in JAMA Otolaryngology-Head & Neck Surgery.

Tyler J. Gallagher, M.D., M.P.H., from the Keck School of Medicine at the University of Southern California in Los Angeles, and colleagues examined the clinical association between GLP-1 RAs and chronic cough in a large multicenter cohort study using electronic medical record data from 70 health care organizations. Adults with type 2 diabetes and a prescription of a GLP-1 RA were identified and compared to those prescribed another second-line diabetes medication (cohorts included 427,555 and 1,614,495 participants, respectively).

The researchers found that individuals prescribed a GLP-1 RA had a significantly increased risk for new chronic cough compared with those prescribed any non-GLP-1 RA second-line medication, dipeptidyl peptidase-4 (DPP-4) inhibitor, or sulfonylurea in a propensity score-matched analysis (adjusted hazard ratios, 1.12, 1.18, and 1.32, respectively). This finding was not seen compared with those prescribed a sodium-glucose cotransporter 2 (SGLT2) inhibitor.

After removing patients with a previous diagnosis of gastroesophageal reflux, those prescribed GLP-1 RAs had a significantly increased risk for chronic cough compared with those prescribed any non-GLP-1 RA, DPP-4 inhibitor, SGLT2 inhibitor, or sulfonylurea (adjusted hazard ratios, 1.29, 1.36, 1.14, and 1.25, respectively).

“This cohort study suggests that there is an association between GLP-1 receptor agonist use and new diagnosis of chronic cough,” the authors write. “This association was present even among patients without a diagnosis of gastroesophageal reflux disease.”

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