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Impact of GLP‐1 and GLP‐1/GIP Receptor Agonist Weight Loss Post‐Lung Transplant on Lung Allograft Function

Clinical Transplantation2025Vol. 39(8)

Spenser E. January, Keith A. Fester, Jesus Escamilla, Marlene Cano

Abstract

ABSTRACT Introduction Glucagon‐like peptide‐1 receptor agonist (GLP‐1 RA) and GLP‐1/glucose dependent insulinotropic polypeptide receptor agonist (GLP‐1/GIP RA) use is becoming increasingly common, but there are little data on their use after lung transplantation. Furthermore, obesity is a known cause of lung function decline after lung transplant, but whether weight loss experienced while on these medications leads to improved lung allograft function has not been investigated. Methods This single‐center retrospective study assessed the use of GLP‐1 or GLP‐1/GIP RA therapy in patients after lung transplantation. The primary objective was to determine if weight loss is associated with improved lung function. Secondary endpoints included changes in hemoglobin A1c and incidence of adverse effects. A subgroup analysis was performed on only those who lost the median or greater percent of body weight, and a sensitivity analysis was performed to assess if other variables impacting lung function significantly contributed to the endpoints. Results There were 81 lung transplant recipients who received GLP‐1 or GLP‐1/GIP RA therapy; the average duration of use was 1.4 years. There was significant weight loss and improvement in hemoglobin A1c, but there was no association found between weight loss and improvement in FEV1 or FVC. Side effects were common and led to discontinuation of the medication in 18.5% of patients, but serious side effects were rare. Conclusion Use of GLP‐1 or GLP‐1/GIP RA therapy after lung transplantation was effective at decreasing weight and improving hemoglobin A1c, but this did not lead to improved lung allograft function. Summary In this article examining the use of GLP‐1 and GLP‐1/GIP RA after lung transplantation, there was no significant association between weight loss and an increase in lung allograft function, although approximately half of the patients experienced a rise in FEV 1 and FVC while on therapy. This study included both a subgroup and a sensitivity analysis to assess if significant weight gain was needed to improve lung function and to assess the impact of other variables on lung function. Patients in this study experienced significant improvement in weight and hemoglobin A1c. Side effects were common, but serious side effects were rare.

Abstract

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