Skin Appendage Disord. 2026 May 16. doi: 10.1159/000552598. Online ahead of print.
ABSTRACT
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with a disproportionately high burden of metabolic comorbidities, including obesity, metabolic syndrome, type 2 diabetes mellitus (T2DM), dyslipidaemia, and polycystic ovary syndrome. Despite this, clinical management of HS has historically remained siloed within dermatology, with insufficient integration of cardiometabolic risk management.
SUMMARY: GLP-1 receptor agonists (GLP-1 RAs) - a drug class now established for T2DM, obesity, and cardiovascular risk reduction - have recently emerged as candidate agents for HS. A systematic review published in 2024 and two pivotal real-world studies published in 2025 provide preliminary evidence that GLP-1 RAs improve HS disease activity through both weight loss and direct anti-inflammatory mechanisms. We argue that this evidence base is already sufficient to justify a paradigm shift: GLP-1 RAs should be considered as adjunctive components of a multidisciplinary treatment strategy for HS patients with concurrent cardiometabolic disease. We propose a practical clinical framework for patient selection and monitoring and call for dedicated randomised controlled trials.
KEY MESSAGES: Metabolic comorbidities are mechanistically linked to HS pathogenesis and are inadequately addressed in current clinical practice. GLP-1 RAs offer dual benefit in HS - improving both metabolic outcomes and HS disease activity. Dermatologists should screen every HS patient for cardiometabolic comorbidities and advocate for GLP-1 RA therapy in eligible patients as part of a multidisciplinary approach.
PMID:42454220 | PMC:PMC13368244 | DOI:10.1159/000552598