GLP-1 Receptor Agonists Linked to Reduced Psoriasis Treatment Escalation in Type 2 Diabetics: Analysis

Adults with psoriasis and type 2 diabetes mellitus (T2DM) treated with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) were less likely to require escalation of psoriasis therapy than patients receiving most other antihyperglycemic medications, according to a large retrospective analysis presented as an abstract.

Real-World Data Suggest Anti-inflammatory Benefits Beyond Glycemic Control

Investigators analyzed data from the TriNetX Research Network, identifying adults with psoriasis and T2DM using ICD-10-CM codes. The primary analysis compared patients treated with GLP-1 RAs against a composite cohort receiving non-GLP-1 antihyperglycemic therapies, including insulin, metformin, SGLT2 inhibitors, sulfonylureas, dipeptidyl peptidase-4 inhibitors, meglitinides, thiazolidinediones, and alpha-glucosidase inhibitors. Additional propensity score-matched subgroup analyses compared GLP-1 RAs with insulin, metformin, and SGLT2 inhibitor monotherapy.

Compared with the composite non-GLP-1 RA cohort, GLP-1 RA use was associated with significantly lower risks of psoriatic arthritis (RR, 0.85; P = 0.031), biologic therapy use (RR, 0.81; P = 0.018), corticosteroid use (RR, 0.68; P < 0.0001), methotrexate use (RR, 0.55; P < 0.0001), and cyclosporine use (RR, 0.61; P = 0.031). Similar reductions in psoriatic arthritis, corticosteroid use, and methotrexate use were observed when GLP-1 RAs were compared with insulin alone, while comparisons with metformin monotherapy demonstrated significantly lower risks of corticosteroid and methotrexate use.

The authors noted the findings are biologically plausible, citing prior evidence that GLP-1 RAs reduce expression of IL-17, IL-23, and tumor necrosis factor-α in psoriatic skin and may exert immune-modulating effects independent of metabolic improvement. They also highlighted emerging evidence suggesting SGLT2 inhibitors may similarly reduce cutaneous inflammation, potentially explaining the comparable outcomes observed between the two drug classes.

The investigators cautioned that the study was limited by its retrospective design, reliance on ICD-10 coding, and potential residual confounding, including unmeasured differences in psoriasis severity, medication adherence, and lifestyle factors. 

"Prospective studies should compare the effectiveness of GLP-1 RAs with other antihyperglycemic medications to further inform integrated therapeutic approaches for patients with psoriasis and T2DM," the authors added. 

Source

Vu T, et al. Journal of Drugs in Dermatology. 2026. 25(8):10057.