Single-center Evaluation of Safety & Efficacy of Glucagon-Like Peptide-1 Receptor Agonists in Solid Organ Transplantation

Aug 30, 2022Progress in transplantation (Aliso Viejo, Calif.)

Safety and effectiveness of diabetes drugs called GLP-1 receptor agonists in organ transplant patients

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Abstract

One-hundred eighteen transplant recipients initiated on a GLP1-RA for diabetes management showed statistically significant improvements in blood glucose and hemoglobin A1c levels after 3-12 months.

A 70% majority of patients were kidney transplant recipients, followed by 19.5% liver and 6.8% lung transplant recipients.
Median fasting blood glucose and hemoglobin A1c levels significantly decreased from baseline to 3-12 months post-initiation (P < 0.0001).
Patients experienced a significant weight loss benefit while on GLP1-RA therapy.
The overall rate of adverse drug reactions was low, with 7% reporting nausea, 4.2% developing pancreatitis, and 7.1% experiencing at least one hypoglycemic event.
This evaluation represents the largest cohort assessed for GLP1-RA use in organ transplantation, suggesting it may be both safe and effective.

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Given the negative outcomes associated with uncontrolled diabetes mellitus, non-insulin therapies with glycemic, cardiovascular, and weight-loss benefits in the general population, such as the glucagonlike peptide-1 receptor agonists (GLP1-RA) have become a more alluring therapeutic option in transplant populations. However, limited evidence exists to demonstrate its safety and efficacy in solid organ transplant.This program evaluation included adult kidney, liver, lung transplant recipients initiated on a GLP1-RA for diabetes mellitus management for a minimum of 3 months, had at least one follow-up visit after starting therapy, and had at least one hemoglobin A1c (HbA1c) level drawn between 3-12 months after GLP1-RA initiation. Outcomes were assessed at time of initiation of GLP1-RA (baseline) and 3-12 months post-initiation. Nadir values between 3-12 months were utilized to assess outcomes.One-hundred eighteen patients met study inclusion criteria. Seventy-percent of patients received a kidney transplant, 19.5% received a liver transplant, and 6.8% received a lung transplant. A statistically significant difference was observed in median fasting blood glucose and HbA1c at baseline to 3-12-month nadir (P < 0.0001). A significant weight loss benefit was also observed. The rate of adverse drug reactions was low. Seven-percent of patients experienced nausea, 4.2% developed pancreatitis, and 7.1% reported having had at least one hypoglycemic event.This is the largest study evaluating GLP1-RA in organ transplantation and demonstrates GLP1-RA is both safe and effective. Further assessment on long-term use of these agents on cardiovascular and renal outcomes is still needed. Introduction: Methods: Results: Discussion:

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Single-center Evaluation of Safety & Efficacy of Glucagon-Like Peptide-1 Receptor Agonists in Solid Organ Transplantation

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