Semaglutide improves outcomes for patients with obesity and HS

A retrospective analysis of 30 patients with both hidradenitis suppurativa (HS) and obesity revealed that semaglutide, a GLP-1 agonist, significantly reduced weight while also lowering flare frequency and enhancing quality-of-life. Additionally, the therapy demonstrated notable anti-inflammatory benefits.

HS is a chronic, inflammatory condition of the pilosebaceous unit [1]. The link between HS and obesity is well established; most patients with HS are overweight or obese, and many suffer from insulin resistance. Semaglutide is a GLP-1 receptor agonist that has shown to improve insulin resistance, suppress appetite, and lead to weight loss in overweight and obese patients. Moreover, it has anti-inflammatory effects. This was the rationale for Dr Daniel Lyons (St Vincent’s University Hospital, Ireland) and colleagues to assess the agent in an HS population [2].

The retrospective analysis was conducted between June 2020 and March 2023 and evaluated 30 patients with obesity and varying stages of HS. Participants, primarily women with an average age of 42 years, were treated with a weekly dose of 0.8 mg semaglutide over an average period of 8.2 months. Most participants were Hurley stage II (n=15), followed by stage III (n=11), and stage I (n=4). All participants received concomitant HS treatment; 10 were on treatment combinations. Several outcomes were assessed, including body mass index (BMI), flare frequency, and the Dermatology Life Quality Index (DLQI).

Semaglutide reduced the frequency of HS flare-ups, from once every 8.5 weeks to once every 12 weeks, and significantly improved quality-of-life. Notably, one-third of participants achieved a clinically meaningful reduction in their DLQI scores (corresponding to a DLQI reduction of 4 points or more). Additionally, participants experienced substantial weight loss, with the average BMI decreasing from 43.1 to 41.5 and weight dropping by an average of 6 kg. A third of participants lost more than 10 kg during the treatment period.

Therapy with semaglutide also improved glycaemic control: HbA1c levels decreased from 39.3 to 36.6 mmol/mol. Moreover, the agent showed anti-inflammatory effects, as C-reactive protein (CRP) levels fell from 7.8 to 6.9 mg/L.

“Semaglutide offers significant benefits for managing HS, particularly through weight loss and flare reduction, and improving patients’ quality-of-life,” commented Dr Lyons. These results should be assessed in larger, prospective trials to decide whether semaglutide should be integrated into HS treatment regimens.

1. 
   
   1. Mintoff D, et al. Clin Exp Dermatol 2023; 48:984-90.
   2. Lyons D, et al. Semaglutide for weight loss in obese patients as an adjunctive treatment for hidradenitis suppurativa: its impact on disease control and quality of life. P0111, EADV Congress 2024, 25–28 September, Amsterdam, the Netherlands.

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Posted on 6 November 20246 November 2024