Objective:

To evaluate the effects of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on psoriasis and psoriatic arthritis (PsA).

Approach:

• Review Methodology: A narrative review synthesizing preclinical, clinical, and mechanistic studies on GLP-1 RAs in psoriasis and PsA.

Key Findings:

• GLP-1 RAs, particularly liraglutide and semaglutide, were associated with improvements in Psoriasis Area and Severity Index (PASI) scores.
• Reductions in inflammatory markers and improvements in metabolic measures were observed.
• Histologic improvements in skin lesions and reductions in cytokines such as IL-17, IL-23, and TNF-alpha were reported in some studies.
• Evidence for GLP-1 RAs in PsA was limited, with only two open-label trials identified.
• Some benefits of GLP-1 RAs may extend beyond weight loss, indicating potential direct immunomodulatory effects.

Interpretation:

The findings indicate potential benefits of GLP-1 RAs in managing psoriasis, but evidence for PsA is limited.

Limitations:

• The review was narrative rather than systematic, which may affect the strength of conclusions.
• Most studies were small, observational, open-label, or case-based.
• Short follow-up periods and participant characteristics (obesity/type 2 diabetes) may limit generalizability.
• Distinguishing metabolic effects from direct immunomodulatory effects is challenging.

Conclusion:

GLP-1 RAs require further investigation in PsA, especially in early disease stages.

Sources:

• Frontiers in Immunology