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SGLT2 Inhibitors Linked to Lower Readmission Risk After AE-COPD Hospitalization
At ATS 2026, Sarath Raju, MD, discussed retrospective data linking SGLT2 inhibitor use to reduced 30-day readmissions in patients hospitalized for AE-COPD and diabetes.
Sodium-glucose cotransporter 2 (SGLT2) inhibitors were associated with lower 30-day readmission risk among diabetic patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease (AE-COPD), according to findings presented at the 2026 American Thoracic Society (ATS) International Conference in Orlando, Florida.
In an interview with HCPLive, Sarath Raju, MD, from Johns Hopkins University School of Medicine, highlighted the growing importance of cardiometabolic management in COPD care, emphasizing that the disease extends beyond the lungs and frequently overlaps with cardiovascular disease, heart failure, insulin resistance, and diabetes. He also noticed that drugs for cardiometabolic health may also improve outcomes for patients with COPD.
The retrospective cohort analysis evaluated 11,610 AE-COPD admissions among diabetic individuals receiving diabetes medications across 10 hospitals in Minnesota between 2011 and 2024. Investigators examined whether prescriptions for SGLT2 inhibitors or glucagon-like peptide-1 receptor agonists (GLP-1 RAs) were associated with a lower risk for 30-day readmission or death compared with other diabetes therapies.
Among the cohort, 514 patients were receiving SGLT2 inhibitors, and 587 were prescribed GLP-1 receptor agonists. The composite endpoint of 30-day readmission or death occurred in 15.8% of patients receiving SGLT2 inhibitors, 15.7% on GLP1-RA, and 19.8% in those receiving other diabetes medications.
After multivariable adjustment, SGLT2 inhibitor use was associated with significantly lower odds of the composite outcome (adjusted odds ratio [aOR], 0.71; 95% CI, 0.55 to 0.91) and lower odds of 30-day readmission alone (aOR, 0.74; 95% CI, 0.57 to 0.95). Time-to-event analyses similarly suggested reduced risk among patients receiving SGLT2 inhibitors.
Although GLP-1 receptor agonists demonstrated trends toward benefit (composite aOR 0.85, 95% CI, 0.67 to 1.07 and 30-day readmission aOR 0.83, 95% CI, 0.65 to 1.06), associations did not reach statistical significance.
He added that the relationship between diabetes and pulmonary disease may be bidirectional, with emerging evidence suggesting insulin resistance and metabolic syndrome may directly worsen lung health. Ruju said that future research needs to examine whether treatment for diabetes could improve lung health.
He also said future investigations should determine whether the apparent benefit stems primarily from reduced cardiovascular events, direct pulmonary effects, or broader systemic improvements. Raju emphasized the need for more mechanistic and prospective studies before cardiovascular health interventions can be incorporated into post-exacerbation COPD treatment strategies.
“Are these [medications] reducing cardiovascular events after hospitalization? Are they [first] reducing the risk for COPD exacerbations?” he wondered.
Raju noted that the findings reinforce growing recognition that COPD management requires attention to systemic disease processes and cardiometabolic health.
“We’re trying to move away from treating COPD as a disease that affects one organ,” Raju said. “[COPD] affects multiple organs, and…people with COPD are often more likely to die from cardiovascular causes.”
Raju has no reported disclosures.
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