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Use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) may be associated with chronic cough, as published in JAMA Otolaryngology–Head & Neck Surgery. A large study of more than 2 million people with type 2 diabetes across 70 healthcare organizations suggests that adults prescribed a GLP-1RA had a 12% higher risk for developing a new cough persisting for more than 8 weeks, compared with people prescribed other medications, including dipeptidyl peptidase-4 (DPP-4) inhibitors, sodium-glucose cotransporter 2 (SGLT2) inhibitors, and sulfonylureas. In the analysis of new chronic cough diagnosis within 5 years of medication initiation, the highest risk was observed among individuals prescribed GLP-1RAs (1.6%), followed by those receiving SGLT2 inhibitors (1.4%), any non–GLP-1RA second-line agent (1.3%), DPP-4 inhibitors (1.0%), and sulfonylureas (0.8%). In addition, the higher risk for developing chronic cough was observed even when a previous gastroesophageal reflux disease diagnosis was excluded from the analysis.
Ask the question: While the increased risk for chronic cough between GLP-1RA users and nonusers is significant, the 5-year absolute risk increase is small, according to researchers. The authors also say, “For clinicians, our findings highlight the importance of asking patients about GLP-1RA use, particularly because many patients use such medication off label and receive prescriptions from clinicians outside of their typical health care team.”