2817-LB: Semaglutide in Kidney Transplant Recipients: Real-World Evidence on Safety and Efficacy

Introduction and Objective: Post-transplant diabetes and pre-existing type 2 diabetes mellitus (T2DM) are common in kidney transplant recipients (KTR) and are associated with increased graft failure and cardiovascular events. GLP-1 receptor agonists (GLP-1 RAs) are a promising therapeutic option; however, safety concerns regarding allograft function have limited their use. This study evaluated the safety and efficacy of semaglutide in KTR with T2DM. Methods: We reviewed 45 KTR with T2DM treated with semaglutide and followed quarterly for up to 12 months. Primary endpoints were changes in HbA1c and eGFR. Secondary endpoints included changes in weight, safety outcomes, and discontinuation rates. Results: The mean age was 56.4 ± 10.3 years, and 53.3% were female. Baseline HbA1c was 7.4 ± 1.2%, eGFR was 67.8 ± 31.1 mL/min/1.73 m², and weight was 88.0 ± 17.8 kg. Semaglutide significantly improved HbA1c (−0.21%, p = 0.030) and weight (−3.35 kg, p = 0.002). Allograft function, measured by eGFR, remained stable (Δ +0.62, p = 0.696), indicating no adverse impact on graft function. The safety profile was consistent with known GLP-1 RA class effects, with gastrointestinal adverse events most frequent (Figure 1). Conclusion: These findings provide real-world evidence that semaglutide improves glycemic control and weight in KTR without compromising allograft function. Future clinical trials are needed to evaluate its long-term safety and efficacy. Disclosure E. Abdelgadir: None. S. Elnour: None. A. Khalifa: None. F. Rashid: Speaker's Bureau; Current; Novo Nordisk, Boehringer Ingelheim International GmbH, Bayer AG, Novartis AG. J. Nafach: None. K. Hafidh: None. A. Khidir: None. F. Alawadi: None.