A US multicentre retrospective cohort study compared Tirzepatide with semaglutide among adults recorded as having both asthma and type 2 diabetes. After one-to-one propensity-score matching, the analysis included 8,176 people in each cohort. Its main result was a near-identical recorded risk of a first asthma exacerbation over 12 months: 11.0 percent for tirzepatide and 11.1 percent for semaglutide.
The adjusted hazard ratio was 1.00, with a 95 percent confidence interval from 0.91 to 1.10. That interval is compatible with modest differences in either direction, but the study did not detect a meaningful difference in the primary outcome.
What the database study measured
The authors used the TriNetX US Collaborative Network. They identified adults with asthma and type 2 diabetes who started tirzepatide or semaglutide between June 2022 and December 2024, then followed outcomes through December 2025. Propensity-score matching was used to balance recorded baseline characteristics before comparing the groups.
The primary outcome was time to a first asthma exacerbation over one year. Secondary outcomes included systemic corticosteroid use and short-acting beta-agonist, or SABA, use. The matched-cohort design is stronger than a simple unadjusted comparison, but it remains observational. Matching can balance information captured in records; it cannot remove all differences in asthma severity, prescribing decisions, inhaler use, access to care or adherence.
A similar primary outcome, one secondary difference
The risk of systemic corticosteroid use was also similar between cohorts, with a reported hazard ratio of 1.01. For SABA use, the tirzepatide cohort had a lower recorded risk, with a hazard ratio of 0.92 and a 95 percent confidence interval from 0.88 to 0.96.
This secondary association should not eclipse the primary result. The study does not establish that tirzepatide changes asthma biology, prevents attacks, or should be chosen for any respiratory purpose. The authors call for randomised controlled trials to clarify the potential role of GLP-1-based medicines in people represented by this database.
Why the null comparison matters
Negative comparative results are often less dramatic than a large numerical difference, but they are valuable. Here, two agents with different receptor profiles showed similar recorded exacerbation risk in a large matched population. That narrows one question while leaving many others open: whether unmeasured clinical differences affected prescribing, whether the endpoint was recorded consistently, and whether a trial with planned respiratory measurements would reproduce the pattern.
Peptra Labs lists Tirzepatide as laboratory reference material. The European research buyer guide, research peptides risk profile and definition of research use only describe the relevant research-only boundary. This article reports the authors’ database findings and is not guidance for human use or a therapeutic claim about a catalogue product.
The appropriate summary is deliberately limited: in 8,176 matched pairs with asthma and type 2 diabetes, the study found similar recorded one-year exacerbation risk for tirzepatide and semaglutide. The smaller difference in recorded SABA use is an observation for further research, not a clinical instruction. Readers comparing language in the laboratory reference catalogue should keep that distinction intact.
References
- Hung CT, 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. Journal of Asthma and Allergy, 7 September 2026. PubMed
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