AT A GLANCE

A new review highlights the potential role of GLP-1 receptor agonists as adjunctive therapy in hidradenitis suppurativa, offering benefits that extend beyond weight loss to possible direct anti-inflammatory effects.

Hidradenitis suppurativa (HS) is a debilitating, chronic inflammatory skin disorder strongly associated with obesity and metabolic comorbidities. Although weight reduction is frequently recommended as part of disease management, evidence on the impact of pharmacologic weight-loss interventions remains scarce. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), a drug class widely adopted for type 2 diabetes and obesity, have also demonstrated anti-inflammatory effects in conditions such as psoriasis, raising interest in their role as adjunctive therapy for HS.

This systematic review synthesizes available clinical evidence on GLP-1RAs for HS. The analysis included case reports, small cohort studies, and early observational data that assessed outcomes such as lesion counts, pain severity, drainage, and quality of life in HS patients treated with GLP-1RAs, including semaglutide and liraglutide. Across studies, GLP-1RA use was consistently associated with meaningful weight loss and metabolic improvement, and some patients experienced reduced HS lesion burden and symptomatic relief independent of weight loss. Safety profiles were generally favorable, mirroring known tolerability in metabolic disease populations.

Despite these promising findings, the current literature is limited by small sample sizes, lack of randomized controlled trials, and heterogeneity in patient populations and treatment regimens. Nevertheless, the results suggest a potential dual benefit of GLP-1RAs in HS: metabolic optimization and possible direct modulation of inflammatory pathways. Further prospective trials are warranted to confirm efficacy, establish dosing strategies, and clarify whether GLP-1RAs can be positioned as a standard adjunctive therapy in HS care.

Reference: Sánchez-Feliciano A, Herrera H, Charrow A, Barbieri JS. Glucagon-like peptide-1 receptor agonists in the adjunctive treatment of patients with hidradenitis suppurativa: A systematic review. J Am Acad Dermatol. 2025 Jul 22:S0190-9622(25)02533-2. doi: 10.1016/j.jaad.2025.06.077. Epub ahead of print. PMID: 40706684.