Coadministration of Liraglutide With Tacrolimus in Kidney Transplant Recipients: A Case Series

Pinelli, Nicole R.; Patel, Anita; Salinitri, Francine D.

doi:10.2337/dc13-1066

Cited by 61 publications

(64 citation statements)

References 6 publications

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“…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%

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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

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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

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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

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“…Both effects raise concerns about whether these agents might impact transplant outcomes by changing immunosuppressant absorption and/or immunosuppressant peak concentrations. To date, only one small case series of five subjects has reported on treatment with GLP-1 agonist in kidney transplant recipients (185). Three weeks of liraglutide therapy did not alter tacrolimus levels or dosing in these subjects, and no transplant-specific adverse effects were noted.…”

Section: B Outpatient Glucose Managementmentioning

confidence: 99%

Post-Transplant Diabetes Mellitus: Causes, Treatment, and Impact on Outcomes

Shivaswamy

Boerner

Larsen³

2015

Endocrine Reviews

238

203

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and VA Nebraska-Western Iowa Health Care System (V.S.), Omaha, Nebraska 68105Post-transplant diabetes mellitus (PTDM) is a frequent consequence of solid organ transplantation. PTDM has been associated with greater mortality and increased infections in different transplant groups using different diagnostic criteria. An international consensus panel recommended a consistent set of guidelines in 2003 based on American Diabetes Association glucose criteria but did not exclude the immediate post-transplant hospitalization when many patients receive large doses of corticosteroids. Greater glucose monitoring during all hospitalizations has revealed significant glucose intolerance in the majority of recipients immediately after transplant. As a result, the international consensus panel reviewed its earlier guidelines and recommended delaying screening and diagnosis of PTDM until the recipient is on stable doses of immunosuppression after discharge from initial transplant hospitalization. The group cautioned that whereas hemoglobin A1C has been adopted as a diagnostic criterion by many, it is not reliable as the sole diabetes screening method during the first year after transplant. Risk factors for PTDM include many of the immunosuppressant medications themselves as well as those for type 2 diabetes. The provider managing diabetes and associated dyslipidemia and hypertension after transplant must be careful of the greater risk for drug-drug interactions and infections with immunosuppressant medications. Treatment goals and therapies must consider the greater risk for fluctuating and reduced kidney function, which can cause hypoglycemia. Research is actively focused on strategies to prevent PTDM, but until strategies are found, it is imperative that immunosuppression regimens are chosen based on their evidence to prolong graft survival, not to avoid PTDM. (Endocrine Reviews 37: 37-61, 2016)

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Pharmacotherapy for Weight Loss in Cirrhosis and Liver Transplantation: Translating the Data and Underused Potential

2021

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BaCKgRoUND aND aIMS: Thirty percent of patients with cirrhosis are obese and the prevalence of obesity increases after transplant to >40% post-transplant. There are currently four weight loss medications approved by the FDA for treatment of obesity (orlistat, phentermine-topiramate, naltrexone-bupropion, and liraglutide). The aim of this review was to investigate the data on the use of these weight loss medications and alternative medicines in patients with cirrhosis and in liver transplant recipients (LTRs). appRoaCH aND ReSUltS: While there is paucity of data for these medications in patients with cirrhosis and LTRs, Liraglutide appears to be generally safe in view of its pharmacokinetic properties. Phentermine-topiramate seems to have the highest weight loss potential but special consideration should be given to neuropsychiatric disorders, cardiovascular comorbidities, and drug interactions. There are emerging data on use of alternative medicines for weight loss but more data are needed. CoNClUSIoNS:The use of weight loss medications is feasible in this patient population but the decision of which medication to prescribe should be individualized based on the degree of renal and hepatic impairment, other co-morbidities, and concomitant medications. (Hepatology 2021;73:2051-2062.O besity is estimated to affect 40% of the United States population and is associated with hepatic, metabolic and cardiovascular morbidities as well as certain cancers and premature death. (1,2) Thirty percent of patients with cirrhosis are obese, while 40% are overweight, and recent analysis of national registry data revealed that 35.9% of adult liver-transplant recipients (LTRs) were obese at the time of transplant. (2,3) In a retrospective study, obesity increased from 23.8% at 4 months to 40.8% 3 years after transplant. (4) Obesity and other components of metabolic syndrome are closely associated with development of NASH, which has become the most common indication for transplantation in women and the second most common indication in men. (5,6) About half of LTRs meet the criteria for metabolic syndrome, placing them at significant risk for long-term cardiovascular and metabolic complications. (7) Weight loss is associated with improvement in NASH and portal hypertension as well as longterm favorable outcomes in general population. (8)(9)(10) Weight loss may enhance future transplant eligibility of patients with cirrhosis and morbid obesity. The parallel increase in prevalence of NASH cirrhosis and obesity highlights the importance of finding a weight-loss strategy that is safe and effective in cirrhosis and LTRs. The data for weight loss-related

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Coadministration of Liraglutide With Tacrolimus in Kidney Transplant Recipients: A Case Series

Cited by 61 publications

References 6 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

Post-Transplant Diabetes Mellitus: Causes, Treatment, and Impact on Outcomes

Pharmacotherapy for Weight Loss in Cirrhosis and Liver Transplantation: Translating the Data and Underused Potential

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