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The Potential for GLP-1s in the Treatment of Psoriatic Arthritis

Medically Reviewed By Alyssa Walton, PharmD

Experts developed medications called glucagon-like peptide 1 (GLP-1) analogs for type 2 diabetes treatment. They’re now a popular weight loss treatment for obesity. Researchers are exploring their potential in other conditions, like inflammatory disorders.

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Other names for GLP-1 analogs include GLP-1 agonists, GLP-1 receptor agonists, and incretin mimetics. Here’s a summary of early evidence and hypotheses for how they might help treat psoriatic arthritis (PsA).

Understanding 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 in response to food. Its actions include:

  • stimulating insulin release
  • inhibiting glucagon release
  • slowing the speed of gastric emptying
  • reducing appetite by increasing satiety

Type 2 diabetes can reduce or prevent these GLP-1 effects. GLP-1 analogs can help restore the insulin-glucagon balance and other effects by mimicking the hormone at its receptors.

The first GLP-1 analog, exenatide (Byetta), received 2005 approval Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source from the Food and Drug Administration as a type 2 diabetes treatment. Research demonstrated that this drug class helped participants manage their blood sugar without the risk of hypoglycemia. Other observed benefits they had on type 2 diabetes included:

  • lowering blood pressure
  • exerting cardioprotective effects
  • reducing body weight

This last effect led to the study and ultimate approval of some GLP-1 analogs as an obesity treatment. GLP-1 analogs can help people with and without type 2 diabetes 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. Some experts consider this a disease-altering amount of weight loss.

GLP-1 hormone receptors are throughout the body. GLP-1 can affect several organ systems, including the cardiovascular, respiratory, nervous, and skeletal systems. An anti-inflammatory effect is among these actions, which created interest in its role in inflammatory disease states, including PsA.

Data on GLP-1 analogs for psoriatic arthritis 

Psoriasis often precedes PsA. According to some studies in a 2019 research review, 40% Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  of people with psoriasis may go on to develop PsA. Experts have shared the presence of an association between psoriasis and diabetes. Having psoriasis may increase the risk of diabetes, and the risk may be higher as psoriasis severity increases.

Conversely, having diabetes may increase Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  the risk of developing psoriasis. This has led experts to hypothesize a pathogenetic link between the two. 

Authors of a 2024 review of GLP-1 analogs in inflammatory arthritis and psoriasis gathered the research to date in these conditions. They included psoriasis and PsA in their literature search.

The authors found 13 basic science or clinical studies on psoriasis. However, none of them reported on PsA outcomes. The review also included five studies in rheumatoid arthritis (RA) and one in gout.

Clearly, a lack of research exists addressing the use of GLP-1 analogs in PsA. The review’s authors pointed out that studies of GLP-1 analogs included minimal representation of people with PsA. 

Results from the data on psoriasis and RA suggested there may be enough evidence to pursue more research into inflammatory conditions and GLP-1 analogs.

In RA, observational studies described improvements in Disease Activity Score 28 in people taking liraglutide (Victoza). 

In psoriasis, human studies similarly found improvements in the Psoriasis Area Severity Index and Dermatology Life Quality Index in favor of GLP-1 analogs in people with psoriasis and type 2 diabetes.

Future research into GLP-1 analogs in inflammatory arthritis must address outcomes in people with PsA. Several questions remain, including whether improvements in arthritis are due to weight loss or an independent anti-inflammatory effect of GLP-1 analogs.

More research may clarify a potential role this drug class has in managing psoriatic diseases.

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