Glucagon-like Peptide-1 Receptor Agonists in Asthma Exacerbations: An Application of High-Dimensional Iterative Causal Forest to Identify Subgroups.

Journal: Pharmacoepidemiology and drug safety
Published Date: Aug 1, 2025

Abstract

BACKGROUND: Glucagon-like Peptide-1 Receptor Agonists (GLP1RA) may reduce asthma exacerbation (AE) risk, but it is unclear which populations benefit most. Recent pharmacoepidemiologic studies have employed iterative causal forest (iCF), a machine learning (ML) algorithm, to identify subgroups with heterogeneous treatment effects (HTEs). While iCF does not rely on prior knowledge of treatment-variable interactions, it may be constrained by missing or poorly defined variables in pharmacoepidemiologic studies.

Authors

  • Tiansheng Wang
    Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China.
  • Jeanny H Wang
    Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.
  • Alan C Kinlaw
    Department of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA.
  • Richard Wyss
    Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • Virginia Pate
    Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.
  • Zhuoyue Gou
    Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA.
  • John B Buse
    Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
  • Corinne A Keet
    Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
  • Michael R Kosorok
    Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Til Stürmer
    Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.

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