GLP-1 receptor agonists in kidney transplant recipients with pre-existing diabetes: a retrospective cohort study
An erratum to this article was published (Lancet Diabetes Endocrinol, Jun 2025 ↗)
Authors' conclusion
GLP-1 receptor agonists were associated with better graft and patient survival. Clinical trials are needed to confirm these findings.
Study context
- Population
- First-time kidney transplant recipients with T2D at transplantation and Medicare as primary insurance, USA, 2013–2020primary cohort
- Participants
- 18,016 recipients
- Exposure
- Post-transplant GLP-1 RA use vs no GLP-1 RA
- GLP-1 receptor agonist usersn = 1,969
- Outcome
- Death-censored graft loss and mortality
Methodological detailsUSA-based, national registry linked with Medicare claims, inverse probability of treatment weights, sensitivity cohort matched on post-transplant survival time
- USA-based
- National registry linked with Medicare claims
- Inverse probability of treatment weights
- Sensitivity cohort matched on post-transplant survival time
Main finding
As reported in the abstract
GLP-1 RA use vs no use, death-censored graft loss, aSHR (95% CI 0.36-0.71; p=0.0001); 49% lower incidence
0.51
GLP-1 RA use vs no use, mortality, aHR (95% CI 0.55-0.86; p=0.001); 31% lower mortality
0.69
Observational data: associations, not effects.
Further findings
Unadjusted cumulative incidence of death-censored graft loss, cohort matched on survival time · 5 years · unadjusted
Gray's test p=0.004
Unadjusted cumulative incidence of mortality, cohort matched on survival time · 5 years · unadjusted
log-rank p=0.0006
Unadjusted cumulative incidence of mortality · 5 years · unadjusted
log-rank p<0.0001
Death-censored graft loss and mortality, cohort matched on survival time
- GLP-1 RA use vs no use, death-censored graft loss, aSHR
- 0.53 (95% CI 0.37-0.75; p=0.0005)
- GLP-1 RA use vs no use, mortality, aHR
- 0.70 (95% CI 0.55-0.88; p=0.003)
- Matched on survival time
Safety
- GLP-1 RA use and DR, aHR (1.11-2.00; p=0.008)
- 1.49
- Safety endpoints rare and not associated with GLP-1 RA, except DR
Original publication
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