16 - Semaglutide Is Effective in Achieving Weight Loss in Liver Transplant Recipients

Monday, October 23, 2023

2:25 PM - 2:35 PM PT

Location: Ballroom B

Presenting Author(s)

Kenneth Chow, MD (he/him/his)

Harbor-UCLA Medical Center
Torrance, CA

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Kenneth Chow, MD¹, Brittney Ibrahim, ², Kabir Rahal, ², Ryan Hsu, BS³, Teresa Tan, PharmD², Katherine Meneses, MSN², Sammy Saab, MD, MPH²
¹Harbor-UCLA Medical Center, Torrance, CA; ²UCLA Medical Center, Los Angeles, CA; ³UCSD School of Medicine, San Diego, CA

Introduction: Orthotopic liver transplantation (OLT) is an effective and life-changing treatment for patients with acute and chronic end-stage liver disease. Although short-term post-OLT survival rates are high, long-term survival rates diminish. Post-OLT obesity and metabolic syndrome are common and are a major risk factor for decreased survival. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) have garnered attention for their ability to promote weight loss in overweight and obese patients with and without diabetes. The purpose of this study was to describe the efficacy of Semaglutide in promoting weight loss in OLT recipients.

Methods: Participants in this study consisted of adult OLT recipients at the UCLA Pfleger Liver Institute who were prescribed Semaglutide any time after transplantation. Patients who took the medication for at least 3 continuous months were included in our study. Demographic and clinical information were collected for each patient and patient weights were recorded at each follow-up visit. Data from the last documented follow-up visit were compared to the data at Semaglutide initiation.

Results: We identified 23 patients who were prescribed Semaglutide after transplantation. The mean age was 65 years and 65 percent were male. Hispanic was the most common ethnicity (44%), followed by White (39%) and Asian (4%). [Table] The mean weight at the last follow-up visit was lower than the mean baseline weight (87 kg vs 92 kg, p=0.0024). The mean percent weight change was negative 5 percent. Nineteen patients had a lower weight compared to their baseline, compared to 4 patients who gained weight. [Figure] Reported side-effects included nausea (30%), emesis (26%), early satiety (6%), and diarrhea (2%). Fifteen patients (65%) reported no side-effects.

Discussion: We demonstrated that in our cohort of OLT recipients, the use of Semaglutide led to a substantial decrease in weight. Given the high prevalence of post-OLT NAFLD, GLP-1 RAs such as Semaglutide may have a role in optimizing the associated metabolic comorbidities such as obesity and metabolic syndrome. Future studies are needed to assess the long-term hepatic benefits, if they indeed exist, that GLP-1 RAs confer in OLT recipients.

Figure: A. Boxplot of percentage of weight change at last follow-up visit compared to baseline. B. Patient weight over time. The grey lines represent each individual patient’s weight over time. The blue line represents a moving average of patient weight with a 10-month time window.

Age, years (mean, SD)		64.7 (9.9)
Sex	Male	15 (65.2%)
	Female	8 (34.8%)
Ethnicity	Asian	1 (4.3%)
	Hispanic	10 (43.5%)
	Non-Hispanic White	9 (39.1%)
	Declined to answer	3 (13.0%)
Indication for transplant	Acute hepatic necrosis	2 (8.7%)
	Alcohol-related liver disease	17 (73.9%)
	Alpha-1-antitrypsin deficiency	1 (4.3%)
	Hepatitis C	3 (13.0%)
Duration between transplant and Semaglutide initiation, months (mean, SD)		136.4 (102.6)
Duration of follow-up, months (mean, SD)		17.0 (10.7)
Indication for Semaglutide	Diabetes mellitus	16 (69.6%)
	Non-alcoholic fatty liver disease	1 (4.3%)
	Obesity	6 (26.1%)
Weight, kg (mean, SD)	Baseline	91.5 (19.2)
	Last follow-up visit	87.4 (19.6)
Comorbidities	Coronary artery disease	4 (17.4%)
	Diabetes mellitus	22 (95.7%)
	Hyperlipidemia	6 (26.1%)
	Hypertension	15 (65.2%)
	Obesity	14 (60.9%)
Immunosuppressant medications at baseline	Cyclosporine	3 (13.0%)
	Everolimus	1 (4.3%)
	Mycophenolate mofetil	15 (65.2%)
	Prednisone	8 (34.8%)
	Tacrolimus	20 (87.0%)

Table: Patient demographics, Semaglutide duration and indication, comorbidities, and medication history.

Disclosures:

Kenneth Chow indicated no relevant financial relationships.

Brittney Ibrahim indicated no relevant financial relationships.

Kabir Rahal indicated no relevant financial relationships.

Ryan Hsu indicated no relevant financial relationships.

Teresa Tan indicated no relevant financial relationships.

Katherine Meneses indicated no relevant financial relationships.

Sammy Saab: AbbVie – Speakers Bureau. Eisai – Advisory Committee/Board Member, Speakers Bureau. Exelisis – Advisory Committee/Board Member, Speakers Bureau. Gilead – Advisory Committee/Board Member, Speakers Bureau. Intercept – Speakers Bureau. Mallinckrodt – Advisory Committee/Board Member, Speakers Bureau. Salix – Speakers Bureau. Takeda – Speakers Bureau.

Kenneth Chow, MD¹, Brittney Ibrahim, ², Kabir Rahal, ², Ryan Hsu, BS³, Teresa Tan, PharmD², Katherine Meneses, MSN², Sammy Saab, MD, MPH², 16, Semaglutide Is Effective in Achieving Weight Loss in Liver Transplant Recipients, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.