GLP-1 Drugs for Psoriasis and PsA: A Growing Debate
GLP-1 Receptor Agonists: A Promising Frontier for Psoriatic disease Management, But Data Gaps Remain
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New research and clinical discussions highlight the potential of GLP-1 receptor agonists (GLP-1 RAs) in managing psoriatic diseases, particularly psoriatic arthritis (PsA), while also underscoring the need for more robust data and addressing practical implementation challenges.
Dermatologists and rheumatologists are increasingly exploring the role of GLP-1 RAs, commonly prescribed for type 2 diabetes and weight management, in treating patients with psoriatic diseases. While anecdotal evidence suggests benefits, experts emphasize that current data is insufficient for widespread recommendations, particularly for general use by dermatologists.
Clinicians Weigh In: Potential Benefits and Practical Hurdles
During a recent conference session, clinicians discussed the emerging interest in GLP-1 RAs for patients with psoriatic diseases. Dr. Soriano noted that for a select group of patients-those who are obese or have type 2 diabetes and have either failed or have contraindications to existing systemic therapies-a trial of a GLP-1 RA could be considered reasonable. However, he stressed the critical need for “much, much better data for recommendations concerning general use by dermatologists.”
The ensuing question-and-answer period revealed practical concerns among physicians. Issues such as insurance approvals, referral processes, and the capacity of busy dermatologists and rheumatologists to manage the complex comorbidities often associated with chronic immune-mediated diseases were raised. Despite these challenges, some physicians shared positive patient experiences, reporting disease advancement with GLP-1 RA treatment, even in the absence of other systemic therapies.
Patient Perspectives: Intrigue Tempered by Caution
Patient research participants (PRPs) also shared their insights,highlighting a similar blend of curiosity and caution regarding GLP-1 RAs. Suzanne Grieb, PhD, a PRP with GRAPPA and an assistant professor at Johns Hopkins University, presented findings from a survey of her peers.
None of the 11 survey respondents had been prescribed GLP-1 RAs. Grieb, who has PsA, stated, “The majority of us described our psoriatic disease as mostly manageable with our current treatment.” However, this did not diminish their interest. The survey indicated that while all participants recognized the importance of exercise and healthy weight for disease management, many struggled with both.Few had discussed specific interventions with their providers.
Three respondents expressed interest in GLP-1s but were uncertain about their accessibility. Grieb elaborated, “Patients ‘are interested in GLP-1s’ impact on our psoriatic disease, but also on other elements of our health, thinking more holistically [about] the benefits that could be achieved through these medications.'”
However, concerns about adding new medications and the potential long-term commitment were also prevalent. Grieb personally noted, ”I don’t meet the requirement for obesity. But I’m overweight,and I could probably benefit from a GLP-1. Without clear weight-related indications, it’s hard, perhaps to be able to justify prescribing it if it’s not going to be available. So it’s a hard conversation [for clinicians] to bring up with their patients.”
Future Directions and Considerations
The discussions underscore a growing recognition of the potential pleiotropic effects of GLP-1 RAs beyond glycemic control and weight loss, extending to inflammatory conditions like psoriatic disease. However, the current evidence base requires notable expansion to support broader clinical adoption. Future research should focus on well-designed clinical trials to elucidate the efficacy and safety of GLP-1 RAs specifically in patients with psoriatic diseases, particularly those with comorbidities. Addressing practical barriers such as insurance coverage and physician education will also be crucial for realizing the potential benefits of these agents for this patient population.
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Kavanaugh has consulted for AbbVie, Amgen, Bristol Myers Squibb, Janssen, Novartis, Pfizer, and UCB. Drucker has received fees for consulting, research, and/or speaking from Altimmune, Amgen, Boehringer Ingelheim, Kallyope, Merck, Novo Nordisk, Pfizer, Sanofi, and Zealand. Fernandez has reported receiving fees and/or funding from Bristol Myers Squibb, Pfizer, Novartis, AbbVie, and Kyowa Kirin. Soriano has received fees and/or funding from AbbVie,Amgen,GlaxoSmithKline,Janssen,Novartis,Pfizer,and UCB. Grieb reported no financial conflicts of interest and stated that she serves as a PRP outside of her capacity as a university faculty member.*