Outcomes of GLP-1 Receptor Agonist Therapy after Liver Transplantation in Patients with Type 2 Diabetes: A Real-World Cohort Study.
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used to manage type 2 diabetes mellitus (T2DM) in liver transplant (LT) recipients, but their impact on graft outcomes remains unclear. This study evaluated clinical and graft-related outcomes associated with GLP-1 RA therapy.
We conducted a retrospective cohort study using the TriNetX Network, identifying adults with LT and T2DM. Two cohorts were defined: LT recipients treated with GLP-1 RAs and those receiving conventional antidiabetic therapy. Propensity score matching (1:1) was applied based on demographics, comorbidities, and immunosuppressive regimens. The index date was the first GLP-1 RA prescription within six months before or after LT. Outcomes assessed at one year included all-cause mortality, graft rejection, graft failure, biliary stricture, hepatic artery thrombosis, and transplant-related infections. Analyses used Kaplan-Meier survival curves and Cox proportional hazards models.
After matching, 704 patients were included in each cohort. GLP-1 RA use was associated with significantly lower mortality (4.2% vs. 12.6%; HR=0.33, 95%CI: 0.22-0.50; p<0.0001) and reduced risks of rejection (9.0% vs. 15.5%; HR=0.55; p=0.0008), graft failure (7.1% vs. 13.8%; HR=0.50; p=0.0002), biliary stricture (4.1% vs. 6.7%; HR=0.60; p=0.0342), infections (5.7% vs. 10.1%; HR=0.54; p=0.0032), and hepatic artery thrombosis (5.4% vs. 10.7%; HR=0.48; p=0.0007).
GLP-1 RA therapy was associated with improved survival and lower rates of major post-transplant complications, suggesting a potential role as preferred antidiabetic therapy in LT recipients with T2DM.
We conducted a retrospective cohort study using the TriNetX Network, identifying adults with LT and T2DM. Two cohorts were defined: LT recipients treated with GLP-1 RAs and those receiving conventional antidiabetic therapy. Propensity score matching (1:1) was applied based on demographics, comorbidities, and immunosuppressive regimens. The index date was the first GLP-1 RA prescription within six months before or after LT. Outcomes assessed at one year included all-cause mortality, graft rejection, graft failure, biliary stricture, hepatic artery thrombosis, and transplant-related infections. Analyses used Kaplan-Meier survival curves and Cox proportional hazards models.
After matching, 704 patients were included in each cohort. GLP-1 RA use was associated with significantly lower mortality (4.2% vs. 12.6%; HR=0.33, 95%CI: 0.22-0.50; p<0.0001) and reduced risks of rejection (9.0% vs. 15.5%; HR=0.55; p=0.0008), graft failure (7.1% vs. 13.8%; HR=0.50; p=0.0002), biliary stricture (4.1% vs. 6.7%; HR=0.60; p=0.0342), infections (5.7% vs. 10.1%; HR=0.54; p=0.0032), and hepatic artery thrombosis (5.4% vs. 10.7%; HR=0.48; p=0.0007).
GLP-1 RA therapy was associated with improved survival and lower rates of major post-transplant complications, suggesting a potential role as preferred antidiabetic therapy in LT recipients with T2DM.
Authors
Nguefang Nguefang, Boateng Boateng, Gyabaah Gyabaah, Konlack Konlack, Issaka Issaka, Luna Landa Luna Landa, Chukwu Chukwu, Eze Eze, Njei Njei
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