NO INITIAL INCREASE IN CANCER RISK WITH GLUCAGON LIKE PEPTIDE-1 THERAPIES FOLLOWING LIVER TRANSPLANTATION

Document Type

Conference Proceeding

Publication Date

10-9-2024

Publication Title

Hepatology

Abstract

Background: Patients who undergo liver transplantation are at higher risk of complications from diabetes and obesity. Recently, Glucagon-like peptide-1(GLP-1) analogues have revolutionized management of these conditions and are increasingly being used in post-transplant patients. However, the safety of these agents in this population, particularly their association with cancer risk, is controversial. We aimed to assess the association of semaglutide and tirzepatide with cancer in patients who undergo liver transplant. Methods: All patients who underwent liver transplant at our institution were included from 1/2018-12/2023. We did a retrospective cohort study to assess whether they received GLP-1 analogues, including semaglutide and tirzepatide, after the liver transplant. Data including patient demographics, comorbidities and exposure to semaglutide or tirzepatide were collected. Primary outcome was development of malignancy. Secondary outcomes were 1-and 3-year mortality. Results: 366 patients were included who underwent liver transplant from 01/2018-12/2023. Of these, 42 (13%) were exposed to semaglutide or tirzepatide while 324 (88%) had no such exposure. The mean age of the population was 58.12 +/- 7.6 in the exposed group and 58.44 +/- 11.5 in the control group. 14(33.6%) were female in the exposed group while (119) 36.7% were female in the control group. Comorbidities, including HTN, stroke and ESRD were comparable in both groups. 37(88.1%) in the exposed group had diabetes while 111(34.2%) in the control group had diabetes(p<0.001). Similarly, 28(66.7%) patients in the exposed group had BMI>30 while 111(34.5%) patients in the control group had BMI>30(p<0.001). The follow up period was 3.74 +/-1.3 years for the exposed group and 4.01 +/-1.5 years in the control group. For outcomes, 2(4.8%) patients in the exposed group were diagnosed with cancer in the follow up period versus 26(8.1%) in the control group (p=0.76). There was no cancer related mortality at one year while at 3 years, it was similar in both groups. For malignancies, 1(50%) patient in the exposed group had HCC, while 5(18%) patients in the control group had either HCC or cholangiocarcinoma. No patients in the exposed group were diagnosed with skin related malignancies including BCC, SCC and Malignant Melanoma, while 13 (46%) patients in the control group were diagnosed with such malignancies. 1 patient in the exposed group was diagnosed with Post Transplant Lymphoproliferative Disorder. 11 patients in the control group were diagnosed with other malignancies including prostate cancer, lymphoma, follicular thyroid cancer, and leukemia. Conclusion: In our cohort, the use of semaglutide and tirzepatide was not associated with cancer in patients who undergo liver transplantation. We were limited by single center and smaller number of patients. Further large scale, multicenter studies are needed to confirm the safety of these medications.

Volume

80

First Page

S1050

Last Page

S1051

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