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

Helen Sweiss, Reed Hall, Dominik Zeilmann, Jesus Escamilla, Suverta Bhayana, Rupal Patel, Christina Long

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: 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. Methods: 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. Results: 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. Discussion: 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.

Original languageEnglish (US)
Pages (from-to)357-362
Number of pages6
JournalProgress in Transplantation
Volume32
Issue number4
DOIs
StateAccepted/In press - 2022

Keywords

  • clinical outcomes
  • clinical outcomes
  • clinical outcomes
  • diabetes
  • diabetes
  • diabetes therapy
  • endocrinology
  • general
  • pharmacology
  • post-transplant
  • type 2
  • weight loss

ASJC Scopus subject areas

  • Transplantation

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