Glucagon-like peptide-1 receptor agonists in hidradenitis suppurativa: A nationwide cohort study

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Abstract

[BACKGROUND] Hidradenitis suppurativa (HS) is associated with obesity, metabolic dysfunction and increased healthcare utilization. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated anti-inflammatory effects and reduction in HS symptoms, but real-world patterns of GLP-1RA use in HS remain limited. [OBJECTIVES] To investigate GLP-1RA use and comorbidity burden among patients with HS compared to matched psoriasis patients and background controls, including changes in healthcare utilization and treatment patterns following GLP-1RA initiation. [METHODS] In this nationwide Danish register-based cohort study, adult patients with HS and age- and sex-matched patients with psoriasis and background controls were included from 1 January 2000 to 31 December 2022. Comorbidities were assessed at the date of HS diagnosis (index date) and at GLP-1RA initiation. Healthcare utilization, surgical procedures and medication use were examined during the 2 years before and after GLP-1RA initiation among patients with HS receiving continuous GLP-1RA treatment and matched HS non-users. [RESULTS] A total of 12,581 patients with HS, 9824 patients with psoriasis, and 12,581 controls were included. During follow-up, 8.2% of patients with HS initiated GLP-1RA treatment, compared with 5.7% of psoriasis patients and 3.2% of controls. Mean time to GLP-1RA initiation was shorter among patients with HS (8.88 years) than psoriasis patients (10.1 years; p < 0.001) and controls (10.2 years; p < 0.001). Cardiometabolic and psychiatric comorbidities increased from index date to treatment initiation across all groups. Following GLP-1RA initiation, lower rates of surgical procedures and systemic medication use were observed. [CONCLUSIONS] Patients with HS demonstrated earlier and more frequent use of GLP-1RA compared with psoriasis patients and controls, with decreased use of HS-specific treatments and surgical procedures following GLP-1RA initiation. Comparable declines were observed among matched non-initiators.

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