GLP-1 receptor agonists: emerging therapeutic potential in psoriasis management - current evidence and future outlook

Psoriasis is a chronic inflammatory skin disease driven by immune dysregulation and often exacerbated by metabolic comorbidities. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), initially developed for type 2 diabetes mellitus (T2DM) and weight management, have emerged as a promising treatment due to their anti-inflammatory and immunomodulatory properties.

This review evaluates the clinical efficacy, mechanisms of action, and limitations of GLP-1RAs, such as liraglutide, exenatide, and semaglutide, in the management of psoriasis.

A comprehensive literature review was conducted, including evidence from case reports, randomized controlled trials, prospective cohorts, and experimental studies, to assess the role of GLP-1RAs in psoriasis treatment.

Evidence suggests that GLP-1RAs mitigate psoriasis severity through systemic effects, including weight loss and improved glycemic control, and local immunomodulation, such as the regulation of invariant natural killer T (iNKT) cells and AMPK activation in psoriatic plaques. These benefits are particularly notable in patients with coexisting metabolic conditions. However, the existing evidence is limited by small cohort sizes, heterogeneous patient populations, and confounding effects of concurrent therapies, limiting its generalizability.

GLP-1RAs offer a novel integrative approach to managing psoriasis by targeting both inflammatory and metabolic pathways. Larger, long-term randomized controlled trials are needed to validate their efficacy, optimize dosing, and determine their role as standalone or adjunctive therapies, particularly in patients without metabolic comorbidities.