GLP-1 Receptor Agonists Significantly Improve Hidradenitis Suppurativa Clinical Outcomes and Reduce Inflammation
Background
Hidradenitis suppurativa (HS) is a debilitating chronic inflammatory skin disease causing pain, disability, and significant comorbidity burden. Its strong association with obesity and metabolic dysfunction often exacerbates disease severity. While Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are established treatments for type 2 diabetes and obesity, their emerging anti-inflammatory and immunomodulatory properties suggest potential benefits in HS. However, robust clinical evidence for their efficacy in this specific patient population has been limited.
Study Design
This systematic review, following PRISMA guidelines and registered with PROSPERO (CRD420251110220), analyzed 19 studies encompassing 67,568 patients to assess the impact of GLP-1 Receptor Agonists on Hidradenitis Suppurativa. Researchers systematically searched PubMed/MEDLINE, Scopus, Web of Science, and Embase through June 2025. Data extracted included clinical severity (Hurley stage), quality of life (DLQI), metabolic and inflammatory markers (C-reactive protein, HbA1c), and healthcare utilization. Pooled analysis was performed where outcomes were consistently reported.
Results
Pooled analysis revealed that > 60% of Hidradenitis Suppurativa patients achieved clinical improvement in Hurley stage (95% CI 52-67%) with GLP-1 Receptor Agonist treatment. The Dermatology Life Quality Index (DLQI) improved by a mean of -3.83 points (95% CI -5.14 to -2.51). These clinical benefits were observed despite only modest weight reduction, with a mean BMI change of -2.64 kg/m2. Inflammatory and metabolic markers also showed significant improvements, including a mean reduction in C-reactive protein of -1.35 mg/L (95% CI -2.33 to -0.36) and HbA1c by -0.39% (95% CI -0.59 to -0.18). Large real-world cohorts demonstrated decreased antibiotic and corticosteroid use, alongside lower hospitalization rates. However, results regarding biologic use, surgical procedures, and cardiovascular outcomes were mixed; two studies reported reduced risk of major adverse cardiovascular events, while one HS-diabetes cohort suggested persistent excess cardiovascular risk compared with diabetes-only controls.
Key Findings
- 60% of HS patients achieved clinical improvement in Hurley stage (95% CI 52-67%) with GLP-1RA treatment.
- Dermatology Life Quality Index (DLQI) improved by a mean of -3.83 points (95% CI -5.14 to -2.51).
- Mean
C-reactive proteinreduced by -1.35 mg/L (95% CI -2.33 to -0.36). - Mean
HbA1creduced by -0.39% (95% CI -0.59 to -0.18). - Real-world data showed decreased antibiotic/corticosteroid use and lower hospitalization rates.
Why It Matters
GLP-1 Receptor Agonists represent a promising adjunctive therapeutic strategy for Hidradenitis Suppurativa, particularly for patients with co-occurring metabolic dysfunction. This review provides strong evidence that these agents can significantly improve disease severity, enhance quality of life, and reduce systemic inflammation, potentially lessening the need for antibiotics and corticosteroids. The observed benefits extend beyond weight loss, highlighting their direct anti-inflammatory actions. While further research is needed to clarify optimal patient selection and long-term cardiovascular impact, these findings support integrating GLP-1RAs into HS management protocols, offering a new avenue for disease control and improved patient outcomes.
glp-1ra
hidradenitis-suppurativa
inflammation
metabolic-syndrome
skin-health
quality-of-life