Publication:

A retrospective study of GLP-1 receptor agonists uses in the management of hidradenitis suppurativa

Background Hidradenitis suppurativa (HS) is a chronic inflammatory disorder frequently associated with metabolic comorbidities. Given the anti-inflammatory and metabolic effects of GLP-receptor agonists (GLP-1Ras), these agents have been proposed as a potential adjunctive therapy for HS.

Methods A retrospective chart review identified 151 HS patients prescribed a GLP-1RA between January 2020 and January 2025. After excluding individuals younger than 18 years and those initiating biologics, long-term immunomodulators, or anti-hormonal therapies after GLP-1RA start, 22 patients met inclusion criteria. Clinical improvement was assessed qualitatively through provider documentation of symptom or disease-status improvement.

Results Among 22 patients, 63.6% demonstrated clinical improvement following GLP-1RA therapy. The cohort included 10 Black, 6 Hispanic, 5 White, and 1 Asian patient. Semaglutide was the most common agent (n=14), followed by tirzepatide (n=7), and exenatide (n=1). Race was significantly associated with improvement (p= 0.025). 92% of non-Black patients improved compared with 30% of Black patients (p= 0.011). This disparity persisted after adjusting for HS severity, treatment duration, comorbidities, insurance type, and income. No significant associations were observed for gender, age, ethnicity, comorbidities, or insurance type.

Conclusions GLP-1RAs may offer symptomatic benefit for HS, with nearly two-thirds of patients showing improvement. However, marked racial differences in response highlight the need for equitable HS research and investigation into biological, structural, and socioeconomic contributors to treatment variability. Larger prospective studies are warranted to clarify therapeutic efficacy and drivers of demographic disparities.