A narrative review published in Clinics in Dermatology reports that GLP-1 receptor agonists have emerged as promising candidates in the management of hidradenitis suppurativa, while noting that not a single randomized controlled trial has tested them in the disease.

GLP-1 receptor agonists are the drug class used widely for type 2 diabetes and obesity. Hidradenitis suppurativa, usually shortened to HS, is a chronic inflammatory skin disease marked by painful nodules, abscesses and draining tunnels in intertriginous areas, the skin folds where surfaces rub together.

Why a diabetes drug is in a skin journal

The link the review builds on is metabolic. HS frequently occurs alongside obesity, insulin resistance and metabolic syndrome, and the authors synthesize the evidence on that metabolic basis before evaluating GLP-1 receptor agonists as adjunctive therapy rather than as a replacement for existing treatment.

That framing matters. Adjunctive is the authors' word, and it is doing real work: nothing here positions this class as a standalone approach to a disease that already has approved biologic options.

What the studies reported

Collectively, the studies gathered in the review report improvements in disease activity measures, in quality-of-life indices, and in healthcare utilization. HS carries a substantial quality-of-life burden, so the second of those is not a throwaway endpoint.

Separately, database analyses demonstrate associations with reduced cardiovascular events and improved extracutaneous outcomes. Associations, in a database, in a patient population already selected for metabolic disease: that is a signal worth chasing, not a result.

Limitations

No randomized controlled trials have evaluated GLP-1 receptor agonists in HS to date. Current evidence is limited to observational studies, uncontrolled trials and case reports.

The authors name three specific problems that limit causal inference: concomitant treatments, lack of control groups, and selection bias. In plain terms, patients in these reports were often taking other things at the same time, there was frequently nobody to compare them with, and the people who ended up in the data may not resemble the people who did not.

Bottom line

The review's own conclusion is that the findings suggest proof of concept, no more. Rigorous randomized controlled trials with standardized efficacy measures and adequate sample sizes are described as essential before anyone can establish clinical efficacy or define where this drug class belongs in HS care.