Glucagon‐like peptide ‐1 receptor agonists and sodium‐glucose cotransporter ‐2 inhibitors for the treatment of diabetes mellitus in liver transplant recipients
Main finding · HbA1c change, adjusted for DPP-4i treatmentResult — go to the resultEstimate −3.5 % 95% CI −6.1 to −0.95Authors' 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.
Study context
- Population
- Adult liver transplant (LT) recipients with pre-existing or post-transplant diabetes, LT recipient database 1990–2023
- Exposure
- GLP-1 RA, SGLT2i or combination vs DPP-4i
- Outcome
- HbA1c change, adjusted for DPP-4i treatment
- Follow-up
- Up to 12 months
Methodological detailssingle-centre, retrospective analysis of prospectively collected data, linear mixed models
- Single-centre
- Retrospective analysis of prospectively collected data
- Linear mixed models
Main finding
As reported in the abstract
Estimate
−3.5 %
95% CI −6.1 to −0.95
P = 0.0089
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| Weight, adjusted for DPP-4i treatment · up to 12 monthsGLP-1RAs vs DPP-4 inhibitor | −5.2 kg (95% CI −8.7 to −1.7) | P = 0.0039 |
| Weight, adjusted for DPP-4i treatment · up to 12 monthsCombination therapy vs DPP-4 inhibitor | −5.4 kg (95% CI −10.5 to −0.36) | P = 0.04 |
| BMI, adjusted for DPP-4i treatment · up to 12 monthsBetween GLP-1RAs and DPP-4 inhibitor | 1.99 kg/m² (95% CI −3.4 to −0.6) | P = 0.0048 |
| BMI, adjusted for DPP-4i treatment · up to 12 monthsCombination therapy vs DPP-4 inhibitor | −3.4 kg/m² (95% CI −5.5 to −1.3) | P = 0.0015 |
Weight, adjusted for DPP-4i treatment · up to 12 months
- All three groups had significant decreases in mean weight and BMI
Alanine aminotransferase
- ALT levels decreased with GLP-1RA and combination therapy
Safety
- Cases of graft rejection
- two (1.4%)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Glucagon‐like peptide ‐1 receptor agonists and sodium‐glucose cotransporter ‐2 inhibitors for the treatment of diabetes mellitus in liver transplant recipients. Diabetes Obes Metab. Published 26 July 2024. doi:10.
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