Evaluating the Use of Glucagon-Like Peptide 1 Receptor Agonists (GLP1 RA) in a Matched Cohort of Kidney and Liver Transplant Recipients

Document Type

Conference Proceeding

Publication Date

6-1-2023

Publication Title

Am J Transplant

Abstract

Purpose: To assess the safety and efficacy of GLP1 RA in a matched cohort of kidney transplant (KT) and liver transplant (LT) recipients who received these agents compared to patients who did not Methods: This single-center, retrospective analysis evaluated KT and LT recipients who were initiated on a GLP1 RA for at least 3 months (mo) matched to a nonintervention comparator group (non-GLP1 RA) based on organ type and diagnosis of diabetes mellitus present at time of transplant. The primary endpoint was change in hemoglobin A1C (HbA1c) at 6 mo. Secondary endpoints included weight (kg), BMI (kg/m2), insulin requirements, and number of oral diabetic agents (ODAs). Safety outcomes included incidence of adverse events (AEs), biopsy-proven acute rejection (BPAR), graft loss, and mortality. Results: Of the 74 patients included, 37 received GLP1 RA matched to 37 patients who did not. Baseline characteristics shown in Table 1. More patients in the GLP1 RA group were on ODAs and 10 patients (27%) initiated on an agent <1 year from transplant. Change in median HbA1c in GLP1 RA group from baseline to 6 mo was -0.5% [(7.0% (6.4-8.9); 6.5% (5.6-7.3)] compared to +0.6% in the non-GLP1 RA group [(5.8% (5.5-6.8); 6.6% (5.8-7.6)], p=0.53. Median change in total daily insulin units was -13 units vs +15 units in the GLP1 RA vs non-GLP1 RA group (p=0.16). GLP1 RA group median change in weight was -7.4 kg vs -0.3 kg in non-GLP1 RA group (p=0.02). BMI change was -3.1 kg/m2 in GLP1 RA vs +0.7 kg/m2 in non-GLP1 RA, p=0.02. In GLP1 RA group, 7 patients (38.9%) experienced an AEs related to drug with 4 (10.8%) leading to discontinuation. Common AE being abdominal pain. One patient (2.7%) discontinued drug due to cost, 3 patients (8.1%) found it ineffective, and 1 (2.7%) had a drug-unrelated discontinuation. Eight patients (21.6%) in each group experienced BPAR. In the GLP1 RA group, 1 patient had graft loss compared to 2 patients in the non-GLP1 RA. No patient deaths occurred with GLP1 RA while 2 patient deaths in the comparator group. Conclusions: GLP1 RA lowered median HbA1c after 6 mo with subsequent clinically and statistically significant reductions in weight, BMI, and insulin requirements in both KT and LT recipients. AE rates are similar to reported literature. GLP1 RAs are safe and effective at all time points of initiation, including <1 year posttransplant, making them useful agents for management of metabolic complications in this patient population. CITATION INFORMATION: Baik I., Gonzalez H., Jantz A., Poparad-Stezar A., Summers B., Venkat D., Samaniego-Picota M., Fitzmaurice M. Evaluating the Use of Glucagon-Like Peptide 1 Receptor Agonists (GLP1 RA) in a Matched Cohort of Kidney and Liver Transplant Recipients AJT, Volume 23, Issue 6, Supplement 1. DISCLOSURES: I.Baik: None. H.Gonzalez: n/a. A.Jantz: n/a. A.Poparadstezar: n/a. B.Summers: n/a. D.Venkat: n/a. M.Samaniego-picota: None. M.Fitzmaurice: n/a. [Figure presented]

PubMed ID

Not assigned.

Volume

23

Issue

Suppl 1

First Page

S947

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