Case report: GLP1RA for the treatment of diabetes in liver transplanted people. Do they increase the risk of pancreatitis?

Front Endocrinol (Lausanne). 2024 May 8:15:1392371. doi: 10.3389/fendo.2024.1392371. eCollection 2024.

Abstract

The incidence of acute pancreatitis (AP) in liver transplanted people is reported to be 1.5-8%. On the other hand, the evidence for a causal relationship between glucagon-like peptide 1 receptor agonists (GLP1RAs) and pancreatitis in people with type 2 diabetes is still weak. In addition, there are currently no data on a possible increased risk of AP in liver-transplanted individuals with diabetes treated with GLP1RAs. In a population of liver-transplanted individuals with diabetes receiving GLP1RA-based therapy, we reported an incidence of AP of 3.0% (two subjects). No cases were reported in liver-transplanted individuals with diabetes receiving SGLT2 inhibitors, insulin or metformin, neither in kidney or lung-transplanted patients treated with GLP1RAs. In both patients with AP, the only additional risk factor for its development was a history of re-transplantation (liver or combined kidney/liver). For this reason, we suggest particular caution when considering GLP1RAs-based therapies in liver transplanted patients with multiple risk factors for AP, such as a history of repeated and complex abdominal surgery.

Keywords: GLP1RAs; acute pancreatitis; incretin agents; liver transplantation; pancreatitis.

Publication types

  • Case Reports

MeSH terms

  • Diabetes Mellitus, Type 2* / complications
  • Female
  • Glucagon-Like Peptide-1 Receptor Agonists*
  • Humans
  • Hypoglycemic Agents* / adverse effects
  • Hypoglycemic Agents* / therapeutic use
  • Liver Transplantation* / adverse effects
  • Male
  • Middle Aged
  • Pancreatitis* / etiology
  • Risk Factors

Substances

  • Hypoglycemic Agents
  • Glucagon-Like Peptide-1 Receptor Agonists

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was (partially) supported by the Italian Ministry of Health (Ricerca Corrente 2023).