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

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.