GLP-1RA use among patients with hidradenitis suppurativa may reduce comorbidities and complications, and improve mortality, a study suggests.

Publishing their observational findings in a research letter for JAMA Dermatology [link here], the researchers from Wroclaw University of Science and Technology in Poland said GLP-1RAs could have a adjunctive role in reducing the systemic burden of HS, but their results should be confirmed in prospective trials.

The researchers drew from the TriNetX global database to identify patients with HS, propensity score matching 20,477 patients receiving at least two GLP-1RAs scripts (semaglutide, dulaglutide, liraglutide, exenatide or tirzepatide) with the same number of controls.

At 1-year follow-up, GLP-1RAs were associated with reduced risk of:

• All-cause mortality (HR 0.29 [95% CI, 0.23-0.37]; P < .001)
• Major adverse cardiovascular events including ischemic heart disease and heart failure (HR 0.70 [95% CI, 0.59-0.81]; P < .001)
• Cellulitis (HR 0.66 [95% CI, 0.58-0.75])
• Sepsis (HR 0.55 [95% CI, 0.46-0.67])
• Acute kidney injury (HR 0.67 [95% CI, 0.57-0.78] )
• Dialysis (HR 0.33 [95% CI, 0.21-0.52])
• Suicidal ideation or attempts (HR 0.46 [95% CI, 0.33-0.64])

These benefits endured through 2 years of follow-up across all categories, indicating a sustained risk reduction over time, the researchers noted.

The benefits also persisted for patients regardless of whether they had type 2 diabetes, and while the benefits weren’t statistically significant for patients without obesity, they were still “directionally consistent”, the researchers said.

“While GLP-1RAs were originally developed to optimise glycaemic control, their therapeutic potential extends beyond glucose regulation, with evidence suggesting anti-inflammatory and cardiovascular benefits across diverse populations. This retrospective cohort study suggests that GLP-1RAs may confer systemic benefits in patients with HS. However, these findings should not be interpreted solely through the lens of glycaemic control,” the researchers said.

Writing in an accompanying editorial [link here], specialists from the University of California’s dermatology department said GLP-1RAs had emerged as a candidate drug class for the effective management of HS, targeting both disease activity and comorbidities unlike other medicines that focused solely on disease control.

“To our knowledge, this is the first study to specifically examine the relationship between GLP-1RA use and comorbidity risk reduction in individuals with HS, addressing a critical evidence gap at the intersection of inflammatory skin disease and cardiometabolic therapeutics,” the authors said.

However, they stressed the follow-up period for monitoring cardiovascular outcomes was relatively short compared with other trials, particularly considering the cohort had a low baseline risk due to their younger age and female sex.

“Prospective studies with longer-term follow-up are needed to confirm these promising initial findings and more fully characterise the benefits,” they said.