Semaglutide and Liraglutide Consistently Improve Psoriasis and Cardiometabolic Markers in Systematic Review
Background
Psoriasis is a chronic inflammatory skin disease frequently associated with metabolic comorbidities like obesity and type 2 diabetes mellitus (T2DM). Current treatments often target inflammation but may not address underlying metabolic dysfunction. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), widely used for T2DM and obesity, possess anti-inflammatory and immunomodulatory properties, suggesting a potential dual benefit for psoriasis patients, particularly those with metabolic syndrome.
Study Design
A systematic review, adhering to PRISMA 2020 guidelines, comprehensively searched PubMed and Scopus databases up to April 2026. The review included 26 studies evaluating individual GLP-1RAs in patients with psoriasis, encompassing case reports, case series, observational studies, and randomized controlled trials. Data on preclinical, clinical, and safety outcomes were extracted and narratively synthesized to assess agent-specific effects and overall impact on psoriasis and associated comorbidities.
Results
The review identified 26 studies, predominantly involving patients with concomitant obesity and/or T2DM. Across these studies, semaglutide, liraglutide, exenatide, and tirzepatide were consistently associated with improvements in psoriasis severity. These benefits were often accompanied by significant reductions in body weight, glycated haemoglobin (HbA1c), inflammatory markers, and various cardiometabolic risk factors. Experimental and clinical data also suggested direct immunomodulatory effects on pathways central to psoriasis pathogenesis. However, the review also noted reports of paradoxical psoriasiform eruptions and psoriasis exacerbations with some agents, highlighting potential agent-specific differences and individual variability in response. The evidence base was limited by heterogeneity and a scarcity of randomized controlled trials.
Semaglutide and liraglutide demonstrated the most consistent evidence of benefit for psoriasis and metabolic outcomes.
Key Findings
- Semaglutide, liraglutide, exenatide, and tirzepatide improved psoriasis severity.
- Psoriasis improvements were often accompanied by reductions in body weight and glycated haemoglobin.
- GLP-1RAs reduced inflammatory markers and cardiometabolic risk factors.
- Semaglutide and liraglutide showed the most consistent evidence of benefit.
- Paradoxical psoriasiform eruptions or exacerbations were reported with some GLP-1RAs.
Why It Matters
This systematic review highlights that GLP-1RAs offer a promising therapeutic avenue for psoriasis patients, particularly those with co-occurring obesity or T2DM, by simultaneously addressing both skin inflammation and metabolic dysfunction. For individuals managing both conditions, this could mean a single class of medication providing broad benefits, potentially simplifying treatment regimens. While specific protocols are still evolving, the consistent findings for semaglutide and liraglutide suggest these agents warrant further investigation in dedicated psoriasis trials. Clinicians might consider GLP-1RAs as a beneficial option in this specific patient subgroup, though awareness of potential paradoxical skin reactions is crucial.
psoriasis
glp-1-agonist
semaglutide
liraglutide
exenatide
tirzepatide