Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RAs) in Hidradenitis Suppurativa: A Narrative Review of Emerging Evidence.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by painful nodules, abscesses, and draining tunnels involving intertriginous areas. It frequently occurs alongside metabolic dysfunction including obesity, insulin resistance, and metabolic syndrome. HS places a substantial quality-of-life burden on its patients. Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs), widely used for the management of type 2 diabetes and obesity, have emerged as promising candidates in managing HS. This narrative review synthesizes current evidence on the metabolic basis of HS and evaluates the role of GLP-1 RAs as adjunctive therapy. Collectively, these studies report improvements in disease activity measures, as well as in quality-of-life indices and in healthcare utilization. Database analyses demonstrate associations with reduced cardiovascular events and improved extracutaneous outcomes. However, to date, no randomized controlled trials have evaluated GLP-1 RAs in HS. Current evidence is limited to observational studies, uncontrolled trials, and case reports. Concomitant treatments, lack of control groups, and selection bias limit causal inference. While findings suggest there is proof of concept for GLP-1 RA therapy in HS, rigorous randomized controlled trials with standardized efficacy measures and adequate sample sizes are essential to establish clinical efficacy and define the role of GLP-1RAs in the management of HS.