GLP-1 Receptor Agonists Should Be Adjunctive Therapy for Hidradenitis Suppurativa with Cardiometabolic Comorbidities
Background
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease strongly linked to obesity, metabolic syndrome, and type 2 diabetes mellitus (T2DM). Historically, HS management has been siloed within dermatology, often neglecting these significant cardiometabolic comorbidities, which are mechanistically linked to HS pathogenesis. This gap highlights the urgent need for integrated treatment approaches that address both skin inflammation and systemic metabolic dysfunction. GLP-1 RAs, established for T2DM, obesity, and cardiovascular risk reduction, offer a promising dual-action mechanism for HS.
Study Design
This narrative review synthesized existing evidence on GLP-1 receptor agonists (GLP-1 RAs) in Hidradenitis Suppurativa (HS). The authors analyzed findings from a 2024 systematic review and two 2025 real-world studies, evaluating their impact on HS disease activity and concurrent metabolic comorbidities. Based on this evidence, they proposed a practical clinical framework for patient selection and monitoring, advocating for the integration of GLP-1 RAs into a multidisciplinary HS treatment strategy.
Results
The review concluded that GLP-1 RAs improve HS disease activity, attributing this benefit to both weight loss and direct anti-inflammatory mechanisms. Existing evidence, including a 2024 systematic review and two 2025 real-world studies, supports this dual action.
The authors argue this evidence is sufficient to justify a paradigm shift, recommending GLP-1 RAs as adjunctive components in a multidisciplinary treatment strategy for HS patients with concurrent cardiometabolic disease. They emphasized that metabolic comorbidities are mechanistically linked to HS pathogenesis and are currently inadequately addressed in clinical practice. GLP-1 RAs offer a unique opportunity to simultaneously improve metabolic outcomes and HS disease activity, addressing a critical gap in current patient care.
Key Findings
- GLP-1 RAs improve HS disease activity through weight loss and anti-inflammatory effects.
- Metabolic comorbidities are mechanistically linked to HS pathogenesis and are inadequately addressed.
- Evidence from a 2024 systematic review and 2025 real-world studies supports GLP-1 RA use in HS.
- GLP-1 RAs offer dual benefit for both metabolic outcomes and HS disease activity.
- Dermatologists should screen HS patients for cardiometabolic comorbidities and consider GLP-1 RA therapy.
Why It Matters
GLP-1 RAs should be considered as an adjunctive therapy for HS patients with metabolic comorbidities, shifting the treatment paradigm from siloed dermatology to a multidisciplinary approach. This means clinicians should actively screen HS patients for obesity, T2DM, and metabolic syndrome, and advocate for GLP-1 RA therapy when appropriate. While dedicated randomized controlled trials are still needed, the current evidence suggests a significant opportunity to improve both skin disease and systemic health. This could lead to improved patient outcomes by addressing the underlying metabolic drivers of HS, potentially impacting future combination strategies.
glp-1-agonist
hidradenitis-suppurativa
obesity
type-2-diabetes
metabolic-syndrome
inflammation