Post-transplant GLP-1RA or SGLT2 inhibitor use was associated with fewer cardiovascular, graft, renal, and mortality events after liver transplantation.
Evidence
This retrospective chart review studied 457 adults with diabetes after solitary liver or simultaneous liver-kidney transplantation, including 33 patients who received a GLP-1RA or SGLT2i.
Caveat
The exposed group was very small, and the retrospective design leaves the associations vulnerable to confounding despite adjusted and propensity-matched analyses.
Simplified
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1 RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated cardiovascular benefits, but there are little data in solid organ transplant populations. We aimed to assess the effect of GLP-1 RA or SGLT2i on the incidence of post-transplant major adverse cardiovascular events (), graft failure, renal outcomes, and mortality in liver or simultaneous liver-kidney transplant populations.
METHODS: A retrospective chart review of adults with diabetes mellitus and either solitary liver or simultaneous liver-kidney transplantation from January 2012 to March 2022 was completed. The multivariate Cox regression and Fine and Gray competing risk regression analyses were used.
RESULTS: Among 457 patients, 33 received a GLP-1 RA or SGLT2i. The GLP-1 RA/SGLT2i group had a lower incidence of graft failure ( = 0.038), new-onset end-stage renal disease requiring dialysis ( = 0.012), and new-onset post-liver transplant MACE at 5 y (adjusted subdistribution hazard ratio, 0.24; = 0.049; 95% confidence interval, 0.059-0.99). P P P
CONCLUSIONS: After propensity score matching, the incidence of 5-y post-liver transplant MACE-free survival was significantly higher, and mortality was significantly lower in the GLP-1 RA/SGLT2i group. The use of a GLP-1 RA/SGLT2i post-liver transplant was associated with a lower incidence of new-onset MACE, graft failure, and new-onset end-stage renal disease requiring dialysis. There was an improvement in survival after propensity score matching.
Key numbers
0.24
Decrease in New-Onset
Adjusted subdistribution hazard ratio for at 5 years
0.038
Lower Incidence of Graft Failure
Statistical significance for graft failure incidence
0.012
Lower Incidence of New-Onset
Statistical significance for new-onset incidence
Full Text
We can’t show the full text here under this license.
