Journal article
Glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors for the treatment of diabetes mellitus in liver transplant recipients
Diabetes, obesity & metabolism, Vol.26(10), pp.4261-4272
10/2024
DOI: 10.1111/dom.15769
PMID: 39056216
Abstract
Aim: To investigate the efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 (SGLT2) inhibitors in liver transplant (LT) recipients with diabetes. Methods: A single-centre, retrospective analysis of prospectively collected data from an LT recipient database (1990-2023) was conducted. We included adults with pre-existing diabetes and post-transplant diabetes, newly started on GLP-1RAs and/or SGLT2 inhibitors after LT. Metabolic and biochemical parameters and outcomes were collected for up to 12 months after starting medications and were compared to those in patients receiving dipeptidyl peptidase-4 (DPP-4) inhibitors. Statistical analysis included descriptive statistics and linear mixed models. Results: We included participants on GLP-1RAs (n = 46), SGLT2 inhibitors (n = 87), combination therapy (n = 12), and a DPP-4 inhibitor comparator (n = 217). Both GLP-1RAs and combination therapy decreased mean glycated haemoglobin (HbA1c) levels, and combination therapy remained significant when adjusted for DPP-4 inhibitor treatment (-3.5%, 95% CI [-6.1, -0.95]; p = 0.0089) at 12 months. All three groups had significant decreases in mean weight and body mass index, but these remained significant in the GLP-1RA (-5.2 kg, 95% CI [-8.7, -1.7], p = 0.0039 and 1.99 kg/m(2), 95% CI [-3.4, -0.6], p = 0.0048) and combination therapy groups (-5.4 kg, 95% CI [-10.5, -0.36], p = 0.04 and -3.4 kg/m(2), 95% CI [-5.5, -1.3], p = 0.0015) when adjusted for DPP-4 inhibitor treatment at 12 months. Alanine aminotransferase levels decreased with GLP-1RA and combination therapy. There were two (1.4%) cases of graft rejection. Conclusion: We found that GLP-1RAs, SGLT2 inhibitors, and their combination, led to significant weight loss in LT recipients with diabetes. Combination therapy, in particular, lowered HbA1c and alanine aminotransferase levels compared to DPP-4 inhibitors. Further studies are needed to assess long-term safety and efficacy.
Details
- Title: Subtitle
- Glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors for the treatment of diabetes mellitus in liver transplant recipients
- Creators
- Katina Zheng - University of TorontoAmirhossein Azhie - University Health NetworkXiaoting You - University of TorontoMaryam Naghibzadeh - University Health NetworkEunice Tan - University Health NetworkSara Naimimohasses - University Health NetworkVikas S. Sridhar - University of TorontoSarang Gupta - University of TorontoShiyi Chen - University Health NetworkSatya Dash - University Health NetworkCynthia Tsien - University of TorontoNazia Selzner - University of TorontoLeslie Lilly - University of TorontoElmar Jaeckel - University of TorontoMinna Woo - University of TorontoSunita Singh - University of TorontoDavid Cherney - University of TorontoMamatha Bhat - University Health Network
- Resource Type
- Journal article
- Publication Details
- Diabetes, obesity & metabolism, Vol.26(10), pp.4261-4272
- Publisher
- Wiley
- DOI
- 10.1111/dom.15769
- PMID
- 39056216
- ISSN
- 1462-8902
- eISSN
- 1463-1326
- Number of pages
- 12
- Grant note
- Toronto General and Western Hospital Foundation
- Language
- English
- Date published
- 10/2024
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984771653202771
Metrics
4 Record Views