Beyond glycaemic control: GLP-1RAs reduce cardiovascular and psychiatric risk in psoriasis

According to a large analysis, treatment of psoriasis patients with glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs) lowered the risk of death by 78% and their risk of major cardiovascular events by 44%. In addition, GLP-1RAs appeared to mitigate psychiatric comorbidities such as substance and alcohol abuse.

In this retrospective cohort study, the largest of its kind, researchers evaluated real-world data from more than 110 million US patients, identifying 6,096 individuals with psoriasis and either diabetes or obesity [1]. Patients were evenly divided: 3,048 received a GLP-1RA (e.g., semaglutide or liraglutide), while 3,048 were treated with alternative anti-diabetic or anti-obesity therapies. All patients were ≥18 years, received systemic psoriasis therapy, and continued treatment for at least 24 months.

After matching for age, sex, and comorbidities, GLP-1RA users still had a 78% lower risk of death and a 44% lower risk of major cardiovascular events compared with those on alternative therapies. Psychiatric comorbidities were significantly less frequent: the risk of alcohol abuse decreased by 65%, and the risk of substance abuse by nearly 50%.

GLP-1RAs may offer benefits beyond glycaemic and weight control. Mechanistically, the reductions in systemic inflammation and neuropsychiatric risk may be linked to GLP-1 receptor activity in both the immune and central nervous systems. These receptors are expressed in inflammatory pathways and in brain regions regulating mood and reward, suggesting a dual therapeutic role.

Importantly, the safety profile of GLP-1RAs was consistent with previous data, with no increase in adverse events such as hypoglycaemia, nausea, or constipation.

Prof. Ralf Ludwig (University of Lübeck, Germany) concluded that, given the magnitude and consistency of benefit, GLP-1RAs could reshape the therapeutic landscape for psoriasis patients with metabolic comorbidities, offering an integrated approach to systemic inflammation, metabolic health, and psychiatric stability.

1. Ludwig R. GLP-1RA drugs dramatically reduce death and cardiovascular risk in psoriasis patients. Presentation EPS06.05, EADV Congress 2025, 17–20 September, Paris, France.

Medical writing support was provided by Dr Susanne Kammerer and Karin Drooff

Copyright ©2025 Medicom Medical Publishers



Posted on 22 September 202522 September 2025