Semaglutide Reduces Hidradenitis Suppurativa Flares and Improves Quality of Life in Obese Patients

Semaglutide, the active ingredient in the antidiabetic medication Ozempic and the obesity drug Wegovy, may help relieve hidradenitis suppurativa (HS), a common and chronic skin condition, particularly in obese individuals.

Hidradenitis Suppurativa Credit: Ziyad Alharbi

Understanding Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a debilitating skin condition characterized by the recurrent development of painful abscesses and scarring in areas such as the armpits, groin, around the nipples, and anus. Beyond the physical discomfort, HS can significantly impact patients’ quality of life, leading to emotional distress and social isolation. Current treatments include antibiotics, biologics, and surgical interventions, but many patients struggle with side effects or inadequate relief. HS affects approximately one in 100 people worldwide, with obesity being one of the significant risk factors.

Semaglutide as a Potential Treatment

A new therapeutic option is emerging for patients who cannot tolerate currently available treatments. Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, not only aids in weight loss but also possesses anti-inflammatory properties that may help reduce the chronic dermatological inflammation associated with HS, according to a recent study.

Study Overview and Methodology

Research presented at the European Academy of Dermatology and Venereology (EADV) congress held in Amsterdam from September 25 to 28, 2024, involved 30 obese patients suffering from hidradenitis suppurativa. These volunteers took a weekly dose of 0.8 mg of semaglutide for an average duration of 8.2 months. The study measured changes in body mass index (BMI), weight, frequency of HS flares, Quality of Life index (DLQI), and pain levels before and after starting semaglutide treatment. Additionally, researchers examined biochemical markers such as levels of C-reactive protein (CRP), glucose, and hemoglobin A1c (HbA1c).

Key Findings and Interpretations

Key Findings:

• HS Flares: The frequency of HS flares decreased from an average of once every 8.5 weeks to once every 12 weeks.
• Quality of Life (DLQI): Improved from 13/30 to 9/30.
• Weight Loss: Participants lost an average of 6 kilograms.
• BMI Reduction: Decreased from 43.1 to 41.5, moving some patients from class III to class II obesity.
• Biochemical Markers: HbA1c levels decreased from 39.3 to 36.6 mmol/mol, indicating better glycemic control, while CRP levels dropped from 7.8 to 6.9 mg/L, suggesting reduced inflammation.

“It is noteworthy that one-third of patients achieved a reduction in the DLQI score of four points or more, equal to or exceeding the minimal important differences for this index,” the authors specify in their statement.

Expert Insights and Future Directions

“Our results suggest that semaglutide, even at modest doses, can offer substantial benefits in managing HS,” explains Dr. Daniel Lyons, principal researcher at St. Vincent University Hospital in Dublin. “While the role of the medication in promoting weight loss is well established, its potential to reduce the frequency of HS flares could revolutionize the treatment approach for patients struggling with this condition.”

In light of these encouraging data, Dr. Lyons adds that larger-scale randomized controlled trials are essential to confirm these findings and explore the efficacy of higher semaglutide doses. If validated, semaglutide could become a valuable tool in the multidisciplinary management of HS, offering both weight management and dermatological benefits.

Considerations and Ethical Implications

While the results are promising, some participants experienced side effects such as gastrointestinal discomfort, which is common with semaglutide. The long-term safety and efficacy of semaglutide for HS patients still need to be thoroughly evaluated. Patients are advised to consult with their healthcare providers before starting semaglutide for HS, as its use for dermatological purposes is still under investigation and not yet approved by the FDA for this indication.

References

Daniel Lyons, Anusha Louly Nathan, Emily Pender, Gregg Murray, Conor Smith, Brian Kirby, Rosalind Hughes, Semaglutide for weight loss in people with obesity as an adjunctive treatment for hidradenitis suppurativa: its impact on disease control and quality of life, British Journal of Dermatology, Volume 191, Issue 4, October 2024, Pages 631–633, https://doi.org/10.1093/bjd/ljae216