Safety and efficacy of glucagon-like peptide-1 receptor agonists among kidney transplant recipients : a systematic review and meta-analysis
© The Author(s) 2024. Published by Oxford University Press on behalf of the ERA..
Background: Evidence supporting glucagon-like peptide-1 receptor agonists (GLP-1RAs) in kidney transplant recipients (KTRs) remains scarce. This systematic review and meta-analysis aims to evaluate the safety and efficacy of GLP-1RAs in this population.
Methods: A comprehensive literature search was conducted in the MEDLINE, Embase and Cochrane databases from inception through May 2023. Clinical trials and observational studies that reported on the safety or efficacy outcomes of GLP-1RAs in adult KTRs were included. Kidney graft function, glycaemic and metabolic parameters, weight, cardiovascular outcomes and adverse events were evaluated. Outcome measures used for analysis included pooled odds ratios (ORs) with 95% confidence intervals (CIs) for dichotomous outcomes and standardized mean difference (SMD) or mean difference (MD) with 95% CI for continuous outcomes. The protocol was registered in the International Prospective Register of Systematic Reviews (CRD 42023426190).
Results: Nine cohort studies with a total of 338 KTRs were included. The median follow-up was 12 months (interquartile range 6-23). While treatment with GLP-1RAs did not yield a significant change in estimated glomerular filtration rate [SMD -0.07 ml/min/1.73 m2 (95% CI -0.64-0.50)] or creatinine [SMD -0.08 mg/dl (95% CI -0.44-0.28)], they were associated with a significant decrease in urine protein:creatinine ratio [SMD -0.47 (95% CI -0.77 to -0.18)] and haemoglobin A1c levels [MD -0.85% (95% CI -1.41 to -0.28)]. Total daily insulin dose, weight and body mass index also decreased significantly. Tacrolimus levels remained stable [MD -0.43 ng/ml (95% CI -0.99 to 0.13)]. Side effects were primarily nausea and vomiting (17.6%), diarrhoea (7.6%) and injection site pain (5.4%).
Conclusions: GLP-1RAs are effective in reducing proteinuria, improving glycaemic control and supporting weight loss in KTRs, without altering tacrolimus levels. Gastrointestinal symptoms are the main side effects.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:17 |
|---|---|
| Enthalten in: |
Clinical kidney journal - 17(2024), 2 vom: 11. Feb., Seite sfae018 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Krisanapan, Pajaree [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
GLP-1RAs |
|---|
| Anmerkungen: |
Date Revised 29.02.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1093/ckj/sfae018 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM369006429 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM369006429 | ||
| 003 | DE-627 | ||
| 005 | 20240229235303.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240229s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/ckj/sfae018 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1311.xml |
| 035 | |a (DE-627)NLM369006429 | ||
| 035 | |a (NLM)38410684 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Krisanapan, Pajaree |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Safety and efficacy of glucagon-like peptide-1 receptor agonists among kidney transplant recipients |b a systematic review and meta-analysis |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 29.02.2024 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © The Author(s) 2024. Published by Oxford University Press on behalf of the ERA. | ||
| 520 | |a Background: Evidence supporting glucagon-like peptide-1 receptor agonists (GLP-1RAs) in kidney transplant recipients (KTRs) remains scarce. This systematic review and meta-analysis aims to evaluate the safety and efficacy of GLP-1RAs in this population | ||
| 520 | |a Methods: A comprehensive literature search was conducted in the MEDLINE, Embase and Cochrane databases from inception through May 2023. Clinical trials and observational studies that reported on the safety or efficacy outcomes of GLP-1RAs in adult KTRs were included. Kidney graft function, glycaemic and metabolic parameters, weight, cardiovascular outcomes and adverse events were evaluated. Outcome measures used for analysis included pooled odds ratios (ORs) with 95% confidence intervals (CIs) for dichotomous outcomes and standardized mean difference (SMD) or mean difference (MD) with 95% CI for continuous outcomes. The protocol was registered in the International Prospective Register of Systematic Reviews (CRD 42023426190) | ||
| 520 | |a Results: Nine cohort studies with a total of 338 KTRs were included. The median follow-up was 12 months (interquartile range 6-23). While treatment with GLP-1RAs did not yield a significant change in estimated glomerular filtration rate [SMD -0.07 ml/min/1.73 m2 (95% CI -0.64-0.50)] or creatinine [SMD -0.08 mg/dl (95% CI -0.44-0.28)], they were associated with a significant decrease in urine protein:creatinine ratio [SMD -0.47 (95% CI -0.77 to -0.18)] and haemoglobin A1c levels [MD -0.85% (95% CI -1.41 to -0.28)]. Total daily insulin dose, weight and body mass index also decreased significantly. Tacrolimus levels remained stable [MD -0.43 ng/ml (95% CI -0.99 to 0.13)]. Side effects were primarily nausea and vomiting (17.6%), diarrhoea (7.6%) and injection site pain (5.4%) | ||
| 520 | |a Conclusions: GLP-1RAs are effective in reducing proteinuria, improving glycaemic control and supporting weight loss in KTRs, without altering tacrolimus levels. Gastrointestinal symptoms are the main side effects | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a GLP-1RAs | |
| 650 | 4 | |a Type 2 diabetes mellitus (T2DM) | |
| 650 | 4 | |a glucagon-like peptide-1 receptor agonist | |
| 650 | 4 | |a kidney transplantation | |
| 650 | 4 | |a post-transplant diabetes mellitus (PTDM) | |
| 700 | 1 | |a Suppadungsuk, Supawadee |e verfasserin |4 aut | |
| 700 | 1 | |a Sanpawithayakul, Kanokporn |e verfasserin |4 aut | |
| 700 | 1 | |a Thongprayoon, Charat |e verfasserin |4 aut | |
| 700 | 1 | |a Pattharanitima, Pattharawin |e verfasserin |4 aut | |
| 700 | 1 | |a Tangpanithandee, Supawit |e verfasserin |4 aut | |
| 700 | 1 | |a Mao, Michael A |e verfasserin |4 aut | |
| 700 | 1 | |a Miao, Jing |e verfasserin |4 aut | |
| 700 | 1 | |a Cheungpasitporn, Wisit |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical kidney journal |d 2012 |g 17(2024), 2 vom: 11. Feb., Seite sfae018 |w (DE-627)NLM219739579 |x 2048-8505 |7 nnns |
| 773 | 1 | 8 | |g volume:17 |g year:2024 |g number:2 |g day:11 |g month:02 |g pages:sfae018 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/ckj/sfae018 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 17 |j 2024 |e 2 |b 11 |c 02 |h sfae018 | ||