P121 Treatment with semaglutide improves the systemic inflammatory burden associated with hidradenitis suppurativa

Abstract Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by inflammatory nodules, abscesses and draining fistulae. It occurs mainly in intertriginous skin and is associated with the formation of scarring and deep-seated sinus tracts. This condition is often accompanied by comorbidities, including metabolic syndrome and obesity. Biomarkers such as systemic immune–inflammatory index (SII), systemic inflammation response index (SIRI) and neutrophil–lymphocyte ratio (NLR) have been utilized to assess the systemic inflammation associated with HS. Semaglutide, a glucagon-like peptide 1 receptor agonist, has emerged as a promising treatment for obesity in patients with HS. We have previously shown that the addition of semaglutide to standard HS treatment results in an improvement in patients’ quality of life, flare frequency, weight and metabolic markers (Lyons D, Louly Nathan A, Pender E et al. Semaglutide for weight loss in people with obesity as an adjunctive treatment for hidradenitis suppurativa: its impact on disease control and quality of life. Br J Dermatol 2024; 191: 631–3). The aim of our study was to assess whether semaglutide reduces the inflammatory burden in HS and thus improves health outcomes. We report the anti-inflammatory effects of semaglutide in 69 patients treated for the indication of HS and obesity. Data were collected retrospectively from June 2020 to December 2024. Of the total 69 patients, there were 60 women and 9 men, with a mean age was 41.8 years. The majority of patients (n = 54) had Hurley stage II disease, with 10 patients classified as Hurley stage III and 5 as Hurley stage I. Twenty-two patients were established on adalimumab with two on infliximab. Other biologics prescribed alongside semaglutide included brodalumab (n = 8) and secukinumab (n = 1). Nineteen patients were coprescribed metformin, and for 16 patients rescue antibiotics including rifampicin and clindamycin. Eight patients were exclusively treated with semaglutide. The mean (SD) duration of semaglutide treatment was 17.1 months (9.43). The mean dosage was 1 mg once weekly. The mean (SD) NLR decreased from 2.42 (0.74) to 2.33 (0.87) with semaglutide treatment (P = 0.18), with the mean (SD) SII reducing from 756 (322) to 705 (304) (P = 0.08). The mean (SD) SIRI prior to semaglutide treatment was 1.48 (0.69), which increased to 1.57 (1.02) while established on treatment (P = 0.24). Semaglutide can improve not only metabolic control, weight, flare frequency and quality of life, but also systemic inflammation and thus health outcomes (Lyons et al.). Although our findings did not reach statistical significance, the consistent trends observed in inflammatory markers and the established efficacy of semaglutide in weight loss and metabolic improvement suggest that it can enhance health outcomes for this patient population.