Management of Diabetes Mellitus With Glucagonlike Peptide-1 Agonist Liraglutide in Renal Transplant Recipients: A Retrospective Study

Liou, Jaw-Horng; Liu, Y.-M.; Chen, Cheng‐Hsu

doi:10.1016/j.transproceed.2018.03.087

Cited by 39 publications

(62 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There were two reported deaths, both of which appeared to be unrelated to use of dulaglutide. Similar to previous studies, no significant interactions or dose adjustments in immunosuppressive agents were required with dulaglutide …”

Section: Discussionsupporting

confidence: 75%

“…Similar to previous studies, no significant interactions or dose adjustments in immunosuppressive agents were required with dulaglutide. [3][4][5][6] One of the limitations of our study is that it comprised mainly Caucasian males, which can affect the generalizability of results. Additionally, biases may ensue from a relatively small sample size and a retrospective, non-blinded design .…”

Section: Renal Dysfunction Is One Of the Frequent Complications In Sotmentioning

confidence: 98%

“…Despite promising results in the general population, the beneficial effects of GLP‐1 analogs in solid organ transplant (SOT) recipients are yet to be established . To date, the literature reports only three small studies with 18 patients in total (Supporting Information Table S1 in File S1) in which the GLP1‐analog liraglutide was tested in SOT recipients . Our retrospective case series is the first extensive study involving 63 SOT recipients treated with dulaglutide, a long‐acting GLP‐1 analog.…”

Section: Introductionmentioning

confidence: 99%

“…2 To date, the literature reports only three small studies with 18 patients in total (Supporting Information Table S1 in File S1) in which the GLP1-analog liraglutide was tested in SOT recipients. [4][5][6] Our retrospective case series is the first extensive study involving 63 SOT recipients treated with dulaglutide, a long-acting GLP-1 analog.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Largest single‐centre experience of dulaglutide for management of diabetes mellitus in solid organ transplant recipients

Singh

Pesavento

Washburn

et al. 2019

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

Published data regarding the approach to management of diabetes mellitus in solid organ transplant (SOT) recipients are limited. We performed a retrospective chart review of SOT recipients with diabetes, above 18 years of age, who were usisng dulaglutide. There was a sustained, statistically significant reduction in the primary endpoints of weight, body mass index (BMI) and insulin requirement in 63 SOT recipients at 6, 12 and 24 months, respectively. A total of 59, 50 and 13 recipients were followed during 6, 12 and 24 months, with a mean paired difference for weight reduction of 2.07 (P value <0.003), 4.007 (P value <0.001) and 5.23 (P value <0.034) kgs and a BMI reduction of 0.80 (P value <0.001), 1.35 (P value <0.005) and 2.015 (P value <0.045) kg/m 2 , respectively. The mean paired difference for insulin reduction before and after dulaglutide treatment was 5.94 units (P value <0.0002). There was no increased risk of malignancy, cardiovascular morbidity, graft-failure or all-cause mortality. Gastrointestinal manifestations were rare, even in patients with advanced chronic kidney disease (CKD), and required no change in immunosuppressive agents. Thus, dulaglutide may be considered an important option for diabetes management in SOT. K E Y W O R D S dulaglutide, GLP-1 receptor agonist, post-transplant diabetes mellitus, solid organ transplantation

show abstract

Section: Discussionsupporting

confidence: 75%

Section: Renal Dysfunction Is One Of the Frequent Complications In Sotmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Largest single‐centre experience of dulaglutide for management of diabetes mellitus in solid organ transplant recipients

Singh

Pesavento

Washburn

et al. 2019

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

show abstract

“…Hence, they are theoretically safe because the chances of interaction with immunosuppressant medications are low. GLP-1RA are an attractive option for management of post-transplant diabetes, although only a small number of studies evaluated GLP-1RA for this condition [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Study of Glucagon-Like Peptide 1 Receptor Agonists for the Management of Diabetes After Transplantation

2020

View full text Add to dashboard Cite

Introduction: Management of post-transplant diabetes mellitus is challenging; there is a lack of prospective randomized controlled trials for safety and efficacy of antidiabetic medications in solid organ recipients. Glucagon-like peptide 1 receptor agonists (GLP-1RA) are a relatively new class of medications used to manage type 2 diabetes in the general population. They have several benefits besides glycemic control, including weight loss and improved cardiovascular risk. However, they have not been studied extensively in the post-transplant population for safety and efficacy. Methods: We conducted a retrospective study of patients who had received kidney, liver, or heart transplant, had diabetes either pre-or post-transplant, and were treated with GLP-1RA. We identified seven kidney, seven liver, and five heart transplant recipients who had received GLP-1RA. We assessed changes in immunosuppressant levels, rejection episodes, changes in hemoglobin A1c (HbA1c), weight, and body mass index (BMI) while on the GLP-1RA. We also looked at changes in insulin dose, other diabetes medications, heart rate, blood pressure, and renal function. Results: After a mean follow-up period of 12 months, there were no significant changes in tacrolimus (FK506) levels and renal function for the period of GLP-1RA use. At the end of 12 months, the mean drop in weight was 4.86 kg [95% CI -7.79, -1.93]. The BMI decreased by a mean of 1.63 kg/m 2 at the end of 12 months [95% CI -2.53, -0.73]. HbA1c decreased from baseline by 1.08% [95% CI -1.65, -0.51], 0.96% [95% CI -1.68, -0.25], and 0.75% [95% CI -1.55, 0.05] at 3, 6, and 12 months, respectively. Conclusions: Our data suggest that GLP-1RA do not affect tacrolimus levels or transplant outcomes in solid organ transplant (SOT) recipients in the short term. GLP-1RA also seem to be as effective in SOT recipients for glycemic control and weight loss as in the non-transplant population with diabetes.

show abstract

Prescribing practices and barriers to use of sodium‐glucose cotransporter 2 inhibitors and glucagon‐like Peptide‐1 receptor agonists in adult kidney transplant recipients: A survey of endocrinology and nephrology prescribers

Walter,

Choksi,

Papaleontiou

et al. 2024

J Am Coll Clin Pharm

View full text Add to dashboard Cite

Clinical practice variability exists regarding the use of sodium‐glucose cotransporter 2 inhibitors (SGLT2i) and glucagon‐like peptide‐1 receptor agonists (GLP‐1RA) in kidney transplant recipients (KTRs). The objective of this study was to understand prescribing practices and barriers for the use of SGLT2i and GLP‐1RA among endocrinology and nephrology prescribers caring for KTRs. A 19‐item electronic survey assessing prescribing practices and barriers for the use of SGLT2i and GLP‐1RA in adult KTRs was distributed to all members of the Planning Research in Inpatient Diabetes/Planning Research in Outpatient Diabetes (PRIDE/PROUD) group and the American Society of Transplantation Kidney Pancreas Community of Practice via email listservs between July and November 2023. Endocrinology and nephrology prescribers caring for adult KTRs with type 2 diabetes mellitus (T2DM) or post‐transplant diabetes mellitus (PTDM) were eligible. A total of 50 responses were included for analysis (n = 25 endocrinology, n = 25 nephrology). Respondents prescribed SGLT2i and GLP‐1RA to adult KTRs with T2DM/PTDM with the following frequency: always (4% SGLT2i, 6% GLP‐1RA), often (34% SGLT2i, 30% GLP‐1RA), sometimes (34% SGLT2i, 36% GLP‐1RA), rarely (22% SGLT2i, 20% GLP‐1RA), or never (6% SGLT2i, 8% GLP‐1RA). The most common indication for both drug classes was diabetes mellitus (DM)/hyperglycemia (84% SGLT2i, 90% GLP‐1RA). Most prescribers felt comfortable initiating a SGLT2i (58%) or GLP‐1RA (62%) between 1 and 6 months post‐transplant. Prescribers were always or often concerned about infection (67%) with the use of SGLT2i and gastrointestinal intolerance (66%) with GLP‐1RA. Cost of treatment/insurance coverage/need for prior authorization and patient concern for drug cost was identified as being very likely or likely barriers for prescribing these drug classes post‐transplant (54% SGLT2i, 62% GLP‐1RA). SGLT2i and GLP‐1RA are prescribed mainly for DM/hyperglycemia by endocrinology and nephrology prescribers between 1 and 6 months postkidney transplant. Concerns surrounding medication access and cost were the most frequently reported barriers to use.

show abstract

Management of Diabetes Mellitus With Glucagonlike Peptide-1 Agonist Liraglutide in Renal Transplant Recipients: A Retrospective Study

Cited by 39 publications

References 11 publications

Largest single‐centre experience of dulaglutide for management of diabetes mellitus in solid organ transplant recipients

Largest single‐centre experience of dulaglutide for management of diabetes mellitus in solid organ transplant recipients

A Retrospective Study of Glucagon-Like Peptide 1 Receptor Agonists for the Management of Diabetes After Transplantation

Prescribing practices and barriers to use of sodium‐glucose cotransporter 2 inhibitors and glucagon‐like Peptide‐1 receptor agonists in adult kidney transplant recipients: A survey of endocrinology and nephrology prescribers

Contact Info

Product

Resources

About