Abstract: FR-PO852
Safety and Efficacy of Long-Term Use of GLP-1RA in Post-Transplant Diabetes Mellitus (PTDM): Analysis of Dulaglutide vs. Liraglutide
Session Information
- Transplantation: Clinical - Outcomes
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Mallik, Ritwika, The Royal London Hospital, London, London, United Kingdom
- Mukuba, Dorcas, The Royal London Hospital, London, London, United Kingdom
- Casabar-Licayan, Mahalia, The Royal London Hospital, London, London, United Kingdom
- Fan, Stanley, The Royal London Hospital, London, London, United Kingdom
- Mccafferty, Kieran, The Royal London Hospital, London, London, United Kingdom
- Ali, Omer, The Royal London Hospital, London, London, United Kingdom
- Yaqoob, Muhammad Magdi, The Royal London Hospital, London, London, United Kingdom
- Chowdhury, Tahseen Ahmad, The Royal London Hospital, London, London, United Kingdom
Background
GLP-1RA are increasingly used in PTDM patients with limited long-term safety and efficacy data. We reviewed the real-world data of the use of Dulaglutide versus Liraglutide in our centre.
Methods
Retrospective analysis was performed in kidney transplant recipients with PTDM and T2D treated for a minimum of 6 months on GLP-1RA therapy. Changes in clinical and biochemical parameters, doses of insulin and immunosuppressive medications, rejection episodes and graft function were assessed.
Results
17 patients were on Dulaglutide and 6 on Liraglutide. Mean age was 56 ± 8.5 years, 65% male, 61% South-Asian and 22% White. Between-group differences in change of weight, blood pressure (BP), HbA1C, alanine transaminase (ALT), creatinine, eGFR and urine protein: creatinine ratio (uPCR) was not statistically significant at 6, 12 and 24 months. Both treatments resulted in decreased weight (more marked with liraglutide at 24 months), HbA1C (more marked in Dulaglutide at 24 months) and insulin doses compared to baseline. There were no changes in immunosuppressive medication due to GLP-1RA despite universal use of mycophenolate. GLP-1RA were discontinued due to adverse effects in 3 patients.
Conclusion
Addition of GLP-1RA therapy in transplant patients with diabetes was well tolerated, with improvement in glucose control and weight. There was no between-group difference in the parameters. Further prospective randomized control studies are warranted.
| Dulaglutide | Liraglutide | |
| Median [IQR], p value | Median [IQR], p value | |
| Change at 6 months | ||
| Weight: kg | -3.9 [-4.95 to 0.25], p = 0.02 | -2.9 [-5.83 to -0.1], p = 0.21 |
| HbA1C: mmol/mol | -11 [-22 to -3], p =0.02 | -7 [-29.25 to 3.75], p = 0.26 |
| eGFR: ml/min/1.73m2 | -0.5 [-6.25 to 7.5], p = 0.7 | -1.5 [-1.5 to 6.75], p = 0.33 |
| Change at 12 months | ||
| Weight: kg | -0 [-5.8 to 2], p = 0.48 | -6.3 [-6.68 to -3.03], p = 0.02 |
| HbA1C: mmol/mol | -9 [-35 to -1], p = 0.01 | -17.5 [-26.75 to 7], p = 0.16 |
| eGFR: ml/min/1.73m2 | -2 [-8 to 6], p = 0.74 | -3 [-1.5 to 7.25], p = 0.31 |
| Change at 24 months | ||
| Weight: kg | -1.75 [-11.38 to 4.2], p = 0.52 | -6 [-6.3 to -3.55], p = 0.03 |
| HbA1C: mmol/mol | -19 [-53.5 to -9.5], p = 0.05 | -19 [-22 to 6], p = 0.23 |
| eGFR: ml/min/1.73m2 | -1.5 [-11.75 to 6.75], p = 0.77 | -2 [-5 to 10.5], p = 0.67 |