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The Potential for GLP-1s in the Treatment of Psoriasis

Medically Reviewed By Alyssa Walton, PharmD

Glucagon-like peptide 1 (GLP-1) analogs, initially type 2 diabetes medications, have also gained approval as a weight loss treatment for obesity. There are some less well-known uses for them that researchers are starting to explore, including psoriasis.

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Glucagon-like peptide 1 (GLP-1) analogs also go by GLP-1 agonists, GLP-1 receptor agonists, and incretin mimetics. Here is a summary of early evidence and hypotheses for how they might treat psoriasis.

A look at glucagon-like peptide 1

GLP-1 is an incretin hormone Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  that works in the gut to stimulate insulin release in response to food. It has additional gut effects that include inhibiting glucagon release, slowing the speed of gastric emptying, and reducing appetite by increasing satiety.

All of these GLP-1 effects can be low or missing in people who have type 2 diabetes. GLP-1 analogs can help restore the insulin-glucagon balance and other effects by stimulating GLP-1 receptors.

Since their approval in 2005 Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  as a type 2 diabetes treatment, a beneficial side effect of GLP-1 analogs has been weight loss. Their approval as an obesity treatment in people with or without diabetes came out of this observation. As a weight loss treatment, they may help people lose more than 10-15% Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  of their body weight. 

As research into GLP-1 continued, various hormone receptors throughout the body were discovered. The hormone can affect several organ systems, including the cardiovascular, respiratory, nervous, and skeletal systems. One of these effects is a dampening of the inflammatory process, which has created interest in its role in inflammatory disease states, including psoriasis.

Data on GLP-1 analogs for psoriasis 

Researchers have known for some time about an association between psoriasis and diabetes. People with psoriasis have an increased risk of diabetes, and the risk increases with psoriasis severity. The reverse Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  also appears to be true, with diabetes increasing the risk of developing psoriasis. As a result, some researchers have proposed a pathogenetic link between the two. 

A recent scoping review looked at the research on GLP-1 analogs in inflammatory arthritis and psoriasis. Preclinical studies included in the review showed the following actions of GLP-1 analogs in psoriasis:

  • decrease in interferon-gamma and interleukin-4 in a dose-dependent manner
  • decrease in interleukin-6, tumor necrosis factor-alpha, and lipopolysaccharide-induced inflammation
  • reduction in keratinocyte proliferation and macrophage migration

The review also included human data to determine whether GLP-1 analogs have a role in treating inflammatory arthritis and psoriasis. Of the conditions included in the review, psoriasis had the most human data available.

Initially, case studies identified unexpected improvements in psoriasis in people taking GLP-1 analogs for diabetes. This improvement, independent of glycemic control and weight reduction, occurred right after starting the GLP-1 analog.

Subsequently, longitudinal cohort studies and randomized controlled trials (RCT) found statistically significant improvements in the Psoriasis Area Severity Index (PASI) and the Dermatology Life Quality Index (DLQI) in favor of GLP-1 analogs in people with psoriasis and type 2 diabetes.

However, the one RCT that investigated GLP-1 treatment in people with psoriasis and obesity who were glucose tolerant found no effect on PASI or DLQI.

Early research shows GLP-1 analogs may help improve psoriasis in people with type 2 diabetes. More research is needed to fully understand whether these drugs have a place in psoriasis treatment, including their effects in people with psoriasis without type 2 diabetes.

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Medical Reviewer: Alyssa Walton, PharmD
Last Review Date: 2024 Jan 4
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