SYSTEMATIC REVIEW article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
This article is part of the Research TopicIncretin-Based Therapies: Economic Sustainability and Health Impact in the Global Management of Metabolic SyndromeView all articles
Safety and Efficacy of Tirzepatide in Transplant Recipients: A Systematic Review and Meta-Analysis
Provisionally accepted
Alessio Provenzani1,2*
Brinn Mancuso2
Riley Stitch2Fabio Tuzzolino1Maria Ausilia Giusti1,2
Alessando Mattina1,2- 1Mediterranean Institute for Transplantation and Highly Specialized Therapies (ISMETT), Palermo, Italy
- 2University of Pittsburgh, Pittsburgh, United States
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Introduction: 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. Methods: 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. Results: 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. Conclusion: 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.
Keywords: adverse drug reactions, efficacy, Safety, tirzepatide, Transplant recipients
Received: 30 Oct 2025; Accepted: 11 Feb 2026.
Copyright: © 2026 Provenzani, Mancuso, Stitch, Tuzzolino, Giusti and Mattina. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Alessio Provenzani
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