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GLP-1RA and reduced mortality, cardiovascular and psychiatric risks in psoriasis: a large-scale cohort study

Henning Olbrich, K. Kridin, H. Zirpel, Gema Hernández, C. Sadik, E. Gaffal, D. Thaçi, R. J. Ludwig

British Journal of Dermatology, 2025

3,048 participants · 18 citations

Abstract

BACKGROUND

Psoriasis is associated with a significant comorbidity burden, especially cardiovascular and metabolic complications. Glucagon-like peptide-1 receptor agonists (GLP-1RA), such as semaglutide, used to treat obesity and diabetes, could potentially reduce comorbidity in patients with psoriasis.

OBJECTIVE

To investigate all-cause mortality, cardiovascular, inflammatory, psychiatric outcomes, and adverse events in psoriasis patients treated with GLP-1RA.

METHODS

This retrospective population-based cohort study utilized real-world data from the US TriNetX database. Patients with psoriasis who were treated for diabetes or obesity with GLP-1RA during the full follow-up period of 2 years were compared with those treated with other systemic anti-diabetic or obesity drugs. After 1:1 propensity-score matching for relevant risk factors, 3,048 participants were included in each cohort. The primary outcomes included the risk of cardiometabolic, psychiatric, and autoimmune sequelae of psoriasis, as well as all-cause mortality and potential adverse drug events. The analysis was repeated using cohorts without psoriasis and results were further validated through two sensitivity analyses involving (i) later follow-up periods, or (ii) exclusion of patients with pustular psoriasis.

RESULTS

In the matched cohorts of 3,048 patients with psoriasis treated with GLP-1RA (60.37% females, mean age 56.94 years, standard deviation [SD] 12.02 years) versus other antidiabetic and obesity drugs…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 3,048 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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