# Safety and efficacy of tirzepatide in transplant recipients: a systematic review and meta-analysis

## TL;DR

This study reviews evidence on tirzepatide's safety and effectiveness in transplant patients, finding it may help manage diabetes and weight with few side effects.

## Contribution

The study is the first to systematically evaluate tirzepatide's use in solid organ transplant recipients.

## Key findings

- Tirzepatide reduced hemoglobin A1c by 1.4% and BMI by 1.2 kg/m² in transplant recipients.
- The drug was well tolerated, with a 3.1% discontinuation rate due to adverse reactions.
- No randomized controlled trials were found, but observational data showed promising results.

## Abstract

Tirzepatide has demonstrated cardiovascular and metabolic benefits in the general population; however, evidence in post-transplant patients is very limited. The aim of this systematic review and meta-analysis is to evaluate the safety and efficacy of tirzepatide in solid organ transplant recipients.

We searched PubMed-MEDLINE, Embase, and Cochrane Library databases. All randomized controlled trials (RCTs) and observational studies were considered. Efficacy outcomes included improvements to glycemic outcomes demonstrated by reductions to hemoglobin A1c and changes to weight, measured by body mass index. Safety was assessed through patients who discontinued tirzepatide treatment due to adverse drug reactions.

No randomized controlled trials (RCTs) or other interventional clinical trials were identified in the available literature. Four non-randomized observational studies were found and included. Using the Weighted Median of the Difference of Medians statistical test, tirzepatide was associated with absolute reductions in hemoglobin A1c of −1.4% (95% CI: −1.7 to −0.4) and body mass index of −1.2 kg/m2 (95% CI: −5.9 to −1.1) in solid organ transplant recipients. Pooled proportions indicated a tirzepatide discontinuation rate of 3.1% (95% CI: 0.0–7.1) due to adverse drug reactions, suggesting the therapy was well tolerated in this population.

Tirzepatide was associated with reductions in hemoglobin A1c and body mass index and was generally well tolerated in solid organ transplant recipients. These findings suggest a potential role for tirzepatide in the management of obesity and post-transplant diabetes mellitus, pending confirmation in larger prospective studies.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251154851, identifier CRD420251154851.