Highlights
- •Evidence regarding incretin based therapies and SGLT2 inhibitors is little in RTRs.
- •Decrease of HbA1c was significant with both DPP-4 inhibitors and SGLT-2 inhibitors.
- •Body weight reduction was significant with SGLT1 inhibitors and DPP-4 inhibitors.
- •Graft function was not adversely affected.
- •Most adverse events were related to gastrointestinal disturbances.
- •Utilization of incretin based therapies and SGLT2 inhibitors in RTRs appear safe.
Abstract
Aims
We aimed to conduct a systematic review and meta-analysis regarding the use of incretin-based therapies including dipeptidyl peptidase-4
(DPP-4) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists as well as
sodium-glucose co-transporter-2 (SGLT2) inhibitors in persons with posttransplantation diabetes mellitus (PTDM) so as to assess both
their efficacy and safety.
Methods
We searched for publications on Kidney/Renal Transplantation and DPP-4 inhibitors,
GLP-1-receptor agonists and SGLT-2 inhibitors and included every study using these
antidiabetics. A p-value < 0.05 was considered statistical significant.
Results
Sixteen studies and 310 individuals with a mean age of 55.98 ± 8.81 years were included
in the analysis. Participants received DPP-4 inhibitors in 8 studies, SGLT-2 inhibitors
in 6 studies and GLP-1 receptor agonists in 2 studies, with a mean follow-up of 22.03 ± 14.95 weeks.
Hemoglobin A1c (HbA1c) reduction was demonstrated in 10 studies (mean +/- standard
deviation (MD) = − 0.38%, I2 = 45%). MD of HbA1c was −0.3741 and −0.4596 mg/dl for DPP-4 inhibitors and SGLT-2
inhibitors respectively. Nine studies demonstrated differences in fasting plasma glucose
(FPG) (MD = – 25,76) and 5 studies in post-prandial glucose (PPG) (MD = – 6.61) before
and following treatment. Most studies did not show adverse effects on the glomerular
filtration rate (GFR) and hepatic function.
Conclusions
DPP-4 inhibitors and SGLT2 inhibitors appear both efficacious and safe in renal transplant
recipients. More high-quality studies are required to guide therapeutic choices for
PTDM.
Keywords
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Article info
Publication history
Published online: December 15, 2020
Accepted:
December 1,
2020
Received in revised form:
August 31,
2020
Received:
May 28,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
