Objective:

To evaluate the potential of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in reducing psoriasis severity specifically in patients with metabolic comorbidities.

Key Findings:

• Small randomized trials suggest 40% to 80% reductions in Psoriasis Area and Severity Index (PASI) scores, particularly in patients with obesity or type 2 diabetes, with sample sizes typically ranging from 7 to 48 and follow-up durations up to 6 months.
• Semaglutide showed a 52% reduction in PASI scores over 12 weeks in a trial with patients having obesity, type 2 diabetes, and psoriasis.
• Liraglutide resulted in an 83% reduction in PASI scores in a trial of patients with type 2 diabetes without obesity.
• The only placebo-controlled trial found liraglutide did not significantly improve PASI scores compared to placebo.
• Observational studies indicated GLP-1 RA use is associated with lower risks of all-cause mortality and major adverse cardiovascular events.

Interpretation:

Psoriasis improvement may be linked to both metabolic and immune effects, including reductions in inflammatory markers and superficial adiposity.

Limitations:

• Evidence is limited by small sample sizes and short follow-up durations, which affect the reliability of findings, with most data derived from patients with obesity or type 2 diabetes.

Conclusion:

GLP-1 RAs may serve as a clinically intriguing adjunct for selected psoriasis patients, but their definitive role in management remains unestablished, and they are not approved for this indication.