The weight loss benefits of GLP-1 agonists have long been established, yet could these drugs have a secondary anti-inflammatory impact? Steven Daveluy, MD, FAAD, director of the Wayne State Dermatology Residency Program, gives the latest in GLP-1s in the treatment of hidradenitis suppurativa (HS) and psoriasis, in this Next Steps in Derm video interview, conducted in partnership with the ODAC Dermatology Conference. As a nationally recognized expert in HS, find out where Dr. Daveluy lands in the use of GLP-1s as medical dermatology treatment. In addition, as patients obtain GLP-1s from other clinicians, learn the role of proactive management of potential dermatologic side effects.
Further Reading
If you want to read more about GLP-1s in dermatology, check out the following articles published in the Journal of Drugs in Dermatology:
ABSTRACT
Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder associated with many comorbidities, including obesity, diabetes, cardiovascular risk factors, mental health issues, and many more disorders. Current treatments including biologics, topicals, and surgical interventions often fall short in terms of patient satisfaction, demonstrating a need for additional innovative approaches that address HS-related comorbidities.
Objective: This review explores the novel application of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in HS treatment, particularly for patients with comorbid conditions such as metabolic syndrome, diabetes, and obesity. Emphasis is placed on combination therapy and the potential for GLP-1RAs to address both HS symptoms and associated comorbidities, with careful consideration of patient selection.
Methods: A review of emerging evidence and existing literature on GLP-1RAs and their applications for weight loss, metabolic regulation, and anti-inflammatory effects was conducted.
Findings: GLP-1RAs offer dual benefits for HS patients by modulating inflammatory pathways and addressing associated comorbid conditions. Case studies and preliminary data suggest that GLP-1RAs may reduce lesion severity, systemic inflammation, and morbidity, either as monotherapy or in conjunction with existing treatments. However, high-quality randomized controlled trials are indicated to confirm these findings.
Conclusion: GLP-1RAs represent a promising adjunctive or standalone treatment choice for those with HS and its related comorbidities. Further research is needed to establish their safety and efficacy in HS treatment.
ABSTRACT
Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for conditions beyond type 2 diabetes, including psoriasis and hidradenitis suppurativa. Despite this, little is known about their dermatologic safety profiles.
Methods: We analyzed FDA Adverse Event Reporting System (FAERS) data from 2018 to 2024 for semaglutide, liraglutide, exenatide, and dulaglutide. Cutaneous adverse events (AEs) were identified using MedDRA-coded terms: “rash,” “pruritus,” “urticaria,” “alopecia,” and “angioedema”. Frequency and proportional reporting ratios (PRRs) were calculated using dipeptidyl peptidase-4 (DPP-4) inhibitors as a comparator. Logistic regression assessed predictors of cutaneous AEs, with dulaglutide as a reference and sex, age, and GLP-1 RA type as independent variables.
Results: Cutaneous AEs were reported in up to 8.16% of GLP-1 RA cases, more often in females, with a mean patient age of 60. Semaglutide was associated with the highest rate, and dulaglutide the lowest. PRR analysis (0.27; 95% CI: 0.257-0.284) showed these AEs were proportionally less common relative to DPP-4 inhibitor users. Exenatide was associated with increased odds (OR = 5.01, 95% CI: 4.69–5.35), while liraglutide and semaglutide showed decreased odds.
Discussion: Possibly influenced by dosage, immune modulation, and patient perception of efficacy, cutaneous GLP-1RA adverse effects were less frequent than DPP-4 inhibitors, but still warrant clinician awareness. These reactions might impact patient adherence, which highlights the need for further investigation into their mechanisms.
Conclusion: Cutaneous AEs are infrequent but vary by GLP-1 RA. Greater awareness may improve patient counseling as indications expand.
Did you enjoy this video interview? Find more here.