Semaglutide improves hidradenitis suppurativa outcomes
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Key takeaways:
- Hidradenitis suppurativa flares were reduced from an average of once every 8.5 weeks to once every 12 weeks.
- Quality of life improved by at least 4 points in 33.3% of patients.
Semaglutide was shown to reduce hidradenitis suppurativa flares in patients with obesity, according to a study presented at the European Academy of Dermatology and Venereology meeting.
“This study suggests that semaglutide is a safe and effective weight reduction treatment for this patient cohort and should be considered as part of patient’s management,” Daniel Lyons, MB, BCh, BAO, MRCPI, of St. Vincent’s University Hospital in Dublin and the study’s lead author, told Healio.
Thirty patients with obesity and hidradenitis suppurativa (HS) received a mean weekly dose of 0.8 mg of semaglutide (Ozempic, Novo Nordisk), a glucagon-like peptide (GLP)-1RA, for an average of 8.2 months, in addition to concomitant HS treatment.
HS flare up frequency was reduced from an average of once every 8.5 weeks to an average of once every 12 weeks during the study.
Quality of life, as measured by DLQI, improved by at least 4 points in 33.3% of patients with a mean DLQI reduction of 13 to 9 out of 30 (adjusted P = .001).
Mean BMI reduced from 43.07 kg/m2 to 41.47 kg/m2 during treatment, with mean weight decreasing from 117.7 kg to 111.6 kg (adjusted P < .0001).
The study also found glucose and HbA1c levels to have decreased from 39.32 mmol/mol to 36.61 mmol/mol (adjusted P = .0335), with average C-reactive protein (CRP) levels dropping from 7.78 mg/L to 6.94 mg/L, suggesting better glycemic control and reduced inflammation.
“We hope that our preliminary data will encourage dermatologists to consider weight loss medication as an adjunct to patient’s treatment and inspire further research in the area,” Lyons said.
The study’s retrospective nature and small sample size were its main limitations. Additionally, the study does not allow researchers to extrapolate semaglutide’s effects outside of concomitant medications, according to Lyons.
“The benefits of weight loss on HS symptom activity are well established and Ozempic is a safe and effective medication, even as these data suggest, at modest doses,” he said. “A randomized controlled clinical trial is needed.”
For more information:
Daniel Lyons, MB, BCh, BAO, MRCPI, can be reached at daniellyonskk@gmail.com.
Perspective
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This is a retrospective study of 30 patients with HS with addition of the GLP-1 agonist semaglutide to standard HS treatments. Over half of the patients were on a biologic, and the majority were also on metformin. Various outcomes were reported, including a decrease in patients’ mean weight, improvement in HbA1c and improvement in DLQI. The study is limited by its retrospective nature and the confounding effects of the patients’ concomitant medications.
Although the pathophysiology of HS remains under active investigation, HS is linked to metabolic dysregulation and patients with HS are at higher risk for obesity and diabetes. Metformin is commonly used as an adjunct therapy in HS for its anti-inflammatory effects and reduction of insulin resistance, although its exact mechanism of action in HS is unknown. GLP-1 agonists represent an exciting potential therapeutic class for patients with HS, especially given their risk for metabolic and cardiovascular comorbidities. My personal clinical experience thus far has mirrored the study authors’ finding that GLP-1 agonists appear to have benefit for patients with HS. Dermatologists already prescribe metformin for HS; introducing GLP-1 agonists into our therapeutic armamentarium for HS would not be a far stretch and may have synergistic benefits when given with our other standard HS medications such as biologics. Randomized controlled trials are needed to assess the efficacy of GLP-1 agonists in HS.
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Lyons D, et al. Semaglutide for weight loss in obese patients as an adjunctive treatment for hidradenitis suppurative: Its impact on disease control and quality of life. Presented at: European Academy of Dermatology and Venereology Congress; Sept. 25-28, 2024; Amsterdam.
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