To evaluate the potential of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in reducing psoriasis severity specifically in patients with metabolic comorbidities.
Key Findings:
Small randomized trials suggest 40% to 80% reductions in Psoriasis Area and Severity Index (PASI) scores, particularly in patients with obesity or type 2 diabetes, with sample sizes typically ranging from 7 to 48 and follow-up durations up to 6 months.
Semaglutide showed a 52% reduction in PASI scores over 12 weeks in a trial with patients having obesity, type 2 diabetes, and psoriasis.
Liraglutide resulted in an 83% reduction in PASI scores in a trial of patients with type 2 diabetes without obesity.
The only placebo-controlled trial found liraglutide did not significantly improve PASI scores compared to placebo.
Observational studies indicated GLP-1 RA use is associated with lower risks of all-cause mortality and major adverse cardiovascular events.
Interpretation:
Psoriasis improvement may be linked to both metabolic and immune effects, including reductions in inflammatory markers and superficial adiposity.
Limitations:
Evidence is limited by small sample sizes and short follow-up durations, which affect the reliability of findings, with most data derived from patients with obesity or type 2 diabetes.
Conclusion:
GLP-1 RAs may serve as a clinically intriguing adjunct for selected psoriasis patients, but their definitive role in management remains unestablished, and they are not approved for this indication.
Recognizing sustained switches between the two diseases can prevent premature discontinuation of effective biologics and point toward Janus kinase inhibitors, a 148-patient cohort suggests.
