1392-P: Metabolic Benefits of GLP-1RA and SGLT2i after Kidney Transplantation: A Real-World Experience

Introduction and Objective: Weight gain and hyperglycemia are major challenges after kidney transplantation and result in worse metabolic outcomes. GLP-1RA and SGLT2i have proven benefits in the non-transplant population but data is limited post kidney transplantation. Methods: We conducted a retrospective review of kidney transplant recipients between 12/1/2016 - 8/26/2024 who were prescribed a GLP-1RA, SGLT2i or BOTH for ≥6 months. Baseline characteristics and metabolic outcomes of weight, BMI, and A1C were evaluated using paired t-tests at 6 months after drug(s) initiation. Results: A total of 174 patients were included: 112 GLP-1RA, 37 SGLT2i and 25 BOTH. Drug(s) were initiated at mean of ≥1.8 years after transplant. At baseline, the GLP-1RA group were younger (55 years), more female (55.4%), had more hyperlipidemia (100%) and higher BMI (32.4 kg/m2). There were no differences in race/ethnicity, diabetes diagnosis, hypertension, weight, A1C, or eGFR at baseline between the groups. At 6 months, only the GLP-1RA group had significant reductions in mean weight (-2.44 kg), BMI (-0.97 kg/m2) and A1C (-0.29%). There were no major adverse cardiovascular or renal events. Conclusion: In kidney transplant recipients, GLP1-RA was prescribed more commonly and was more effective in reducing metabolic outcomes of weight, BMI and A1C at 6 months. The SGLT2i and BOTH groups may have been limited by their small size. Larger and more rigorous investigation is warranted in this high-risk population. Disclosure A.R. Sadhu: None. L.W. Moore: None. M. Hasan: None. S. Yi: None. A.O. Gaber: Advisory Panel; Ended; Sanofi. Research Support; Current; Biogen, Alexion Pharmaceuticals, Inc.