A recent study presented at the 2024 European Academy of Dermatology and Venereology (EADV) Congress, and published in the British Journal of Dermatology, suggests that semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1-RA) currently approved for treating diabetes and obesity (BMI >30 kg/m², or >27 kg/m² with related complications), may also be effective in treating hidradenitis suppurativa (HS).
Hidradenitis suppurativa is a common, chronic inflammatory skin condition that primarily affects intertriginous areas such as the armpits, groin and under the breasts. It is characterized by recurrent, painful, and often malodorous abscesses, nodules, and sinus tracts, which often lead to scarring and significant physical discomfort. Beyond the physical symptoms, HS can also have severe psychological impacts on affected individuals, contributing to a substantial decline in quality of life.¹,²
Current treatment options include lifestyle changes, antibiotics, anti-inflammatory and biologic immunosuppressant medications, surgical interventions, and supportive therapies. However, despite these advancements, effective and well-tolerated treatments remain limited.³
Obesity is a well-documented risk factor for developing HS, and previous studies have shown that weight loss through bariatric surgery is associated with a reduction in HS severity.4 Given these connections, researchers at St. Vincent’s University Hospital, Dublin, Ireland, conducted a retrospective analysis to investigate the impact of the weight-loss drug semaglutide on disease control and quality of life in 30 obese patients living with HS. The study included 27 women and 3 men, with an average age of 42 years. These patients received a weekly dose of 0.8 mg of semaglutide over an average period of 8.2 months while continuing with their standard HS treatments.
Key metrics such as body mass index (BMI), weight, flare frequency, quality of life (using the Dermatology Life Quality Index [DLQI]), and serological markers like C-reactive protein (CRP) and haemoglobin A1c (HbA1c) were monitored. A mixed-effects analysis was then performed to measure the significance (P<0.05) prior to and following receipt of semaglutide.
The data showed encouraging improvements after starting semaglutide: the frequency of reported HS flare-ups dropped from an average of every 8.5 weeks (SD=12.9) to every 12 weeks (SD=13.1). The patients also experienced a reduction in their DLQI scores, with an average improvement from 13/30 (SD=8.7) to 9/30 (SD=8.2) (95% CI 1.696 to 10.68, P=0.0014), indicating improvements in quality of life. One-third of the patients achieved a reduction of four points or more on the DLQI scale, equalling or surpassing the minimal clinically important difference for this index.
Patients also saw weight loss benefits. Their average BMI decreased from 43.1 to 41.5, with one-third of the participants losing 10 kg or more. Additionally, HbA1c levels improved, from 39.3 (SD=9.7) to 36.6 (SD=3.4) (95% CI 0.2234 to 9.696, P=0.0335), indicating better blood glucose control. CRP levels, which indicate inflammation, also decreased slightly from 7.8 (SD=6.2) to 6.9 (SD=5.2) (95% CI -2.142 to 5.110, P=0.9503).
Speaking on the results, Dr Daniel Lyons, who led the study, commented, “Even at the lower dose, semaglutide appeared to help patients with both weight management and HS symptoms. The reduction in flare frequency and improvements in quality of life were especially noteworthy.”
These preliminary data are promising and suggest that the addition of semaglutide to usual HS treatment could mark a significant step forward in helping improve the outcomes for people living with this condition. However, as this is the first study investigating semaglutide in HS, further research, particularly randomized, placebo-controlled trials, is essential to confirm the long-term efficacy of semaglutide in this context. Future studies should also explore the effects of higher doses, as the semaglutide dose used in this study was 0.8 mg weekly—substantially lower than the 2.4 mg weekly dose approved for weight loss.
References
- Ballard K, Shuman VL. Hidradenitis Suppurativa. [Updated 2024 May 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
- NHS. (2023). Hidradenitis suppurativa (HS). Retrieved from https://www.nhs.uk/conditions/hidradenitis-suppurativa/ (accessed 1 Oct 2024)
- The Health Policy Partnership. (2024). Call to action: improving the lives of people with hidradenitis suppurative (HS) in the United Kingdom. Retrieved from: https://www.nhs.uk/conditions/hidradenitissuppurativa/ (accessed 1 Oct 2024)
- Canard C, Diaz Cives A, Gaubil-Kaladjian I, Bertin E, Viguier M. Impact of Bariatric Surgery on Hidradenitis Suppurativa. Acta Derm Venereol. 2021 Jun 2;101(6):adv00471. doi: 10.2340/00015555-3830. PMID: 34003299; PMCID: PMC9380277.
Disclosure: This article was created by the touchDERMATOLOGY team utilizing AI as an editorial tool (ChatGPT (GPT-4o) [Large language model]. https://chat.openai.com/chat.) The content was developed and edited by human editors. No funding was received in the publication of this article.
