Hidradenitis Suppurativa: The Role of GLP-1 Receptor Agonists in Reducing Surgical Interventions

GLP-1 receptor agonists are emerging as a potential adjunct in the management of hidradenitis suppurativa (HS), with early evidence suggesting they may reduce reliance on surgical interventions in some patients.

The dual action of GLP-1 receptor agonists on metabolic processes and their potential anti-inflammatory effects have captured attention; they are hypothesized to reduce inflammatory activity in HS, partly through weight loss and metabolic improvements.

Retrospective reports describe fewer hospitalizations and procedures in some cohorts, likely linked to improved lesion severity and systemic inflammation, though formal guideline endorsement is pending.

In real-world and retrospective analyses, GLP-1 RA exposure has been associated with lower hospitalization and surgical events in some patients; causality has not been established.

Managing severe flare-ups remains a primary concern, especially when traditional treatments fall short. This emerging evidence is informing exploratory clinical considerations for HS complications, highlighting the potential adjunctive value of GLP-1 receptor agonists in inflammation management.

For patients who struggle with recurrent hospitalizations, these agents may offer a non-surgical adjunct pending further evidence. These medications promote weight loss and may reduce lesion severity, which is critical in HS management. Real-world reports suggest that strategic use may be associated with decreased need for surgical intervention.

Key Takeaways:

• Evidence for GLP-1 receptor agonists in HS is preliminary and largely observational; associations with reduced hospitalizations and procedures have been reported, but causality is unproven.
• No major HS guidelines currently recommend GLP-1 receptor agonists specifically for HS; interest is growing as data accumulate.
• Potential candidates may include patients with obesity or metabolic comorbidities, where weight loss and metabolic improvements could complement standard HS therapies.
• Prospective trials and standardized outcomes are needed to define efficacy, safety, dosing, and their role alongside existing medical and surgical treatments.