A new study presented at a major dermatology congress suggests that patients with psoriasis who are treated with GLP-1 receptor agonists (GLP-1RAs) may experience substantial reductions in mortality and cardiovascular risk, along with notable decreases in alcohol and substance abuse. The findings come from a large-scale analysis using a vast U.S. patient database and indicate potential benefits beyond weight and glucose control. The research highlights a possible new direction for psoriasis care, particularly for those also dealing with diabetes or obesity, by expanding the potential uses of GLP-1RAs such as semaglutide and liraglutide.
Study Overview and Key Findings
A landmark study assessing the impact of GLP-1 receptor agonists on people with psoriasis has found a striking association with improved survival and cardiovascular outcomes compared with other diabetes or obesity treatments. Among the psoriasis population evaluated, those treated with GLP-1RAs exhibited a 78 percent reduction in the risk of death and a 44 percent reduction in major adverse cardiovascular events (MACE) relative to peers receiving alternative diabetes or obesity therapies. These results, which emerged from a comprehensive analysis conducted during the two-year follow-up window, were presented as part of the 2025 European Academy of Dermatology and Venereology (EADV) congress.
In addition to cardiovascular benefits, the study reported substantial reductions in risky behavioral health outcomes. Specifically, GLP-1RA therapy was associated with a 65 percent lower risk of alcohol abuse and nearly a 50 percent reduction in the risk of substance use disorders when compared with the control group. Taken together, the findings suggest that GLP-1RAs may confer broader protective effects for psoriasis patients beyond their established roles in weight management and glycemic control.
The psoriasis patient population analyzed consisted of more than 6,000 individuals who also had diabetes or obesity. The two-year study period included 3,048 patients who received GLP-1RA therapy and an equally sized group who were treated with other anti-diabetes or anti-obesity medications. The data were drawn from an extensive U.S. database encompassing over 110 million patients, enabling a robust comparison across large cohorts. After accounting for differences in age, sex, and comorbid conditions, the observed advantages of GLP-1RAs remained consistent across multiple sensitivity analyses that used propensity score matching to mitigate potential confounding factors.
The principal investigator and study author, Professor Ralf Ludwig, highlighted in commentary that these results hint at benefits that extend beyond the established effects on weight loss and blood sugar regulation. He noted that the activation of the GLP-1 receptor could suppress pro-inflammatory mediators elevated in psoriasis, potentially contributing to observed cardiovascular and psychiatric outcome improvements. Additionally, he pointed to the presence of GLP-1 receptors in brain regions involved in mood regulation and reward pathways, which could offer a plausible explanation for the reductions in alcohol and substance use observed in the study.
These gains appeared especially pronounced when comparing psoriasis patients on GLP-1RAs with matched control participants who did not receive GLP-1RA therapy. This pattern raises the possibility of a synergistic interaction between systemic inflammation inherent to psoriasis and the mechanisms of GLP-1RAs. Importantly, the safety data in this psoriasis cohort aligned with what is seen in the general population, showing no notable uptick in adverse events such as hypoglycemia, nausea, or constipation.
Professor Ludwig concluded that, given their safety profile and the breadth of observed benefits, GLP-1RAs could emerge as a preferred treatment option for psoriasis patients who also require therapy for diabetes management or weight control. This study’s findings invite further investigation into the role GLP-1RAs may play in modulating inflammation, metabolic health, and behavioral health outcomes in psoriasis.
Population, Data Source, and Methodology
The study utilized a large-scale U.S. health database containing records for more than 110 million patients, allowing researchers to identify a substantial psoriasis cohort with concurrent diabetes or obesity. From this population, researchers focused on a two-year interval during which patients were observed for critical outcomes: all-cause mortality, major cardiovascular events, alcohol misuse, and substance use disorders.
Researchers identified 6,000 psoriasis patients with diabetes or obesity and divided them into two groups for comparative purposes. One group consisted of 3,048 patients treated with GLP-1 receptor agonists, while an equally sized comparison group received other medications used for diabetes or obesity management. This balanced design enabled a direct comparison of outcomes under similar baseline conditions, minimizing confounding influences.
To ensure that differences in demographics or comorbid conditions did not skew results, the team employed propensity score matching. This statistical technique creates matched pairs of patients who are similar across a range of observed characteristics, thereby simulating some aspects of randomization. After adjustment for age, sex, and comorbidities, the observed advantages of GLP-1RA therapy persisted across all sensitivity analyses, reinforcing the robustness of the findings.
The GLP-1 receptor agonists studied include drugs already widely used for type 2 diabetes and obesity management, such as semaglutide and liraglutide. While these agents are not new to the pharmacologic landscape, their potential impact on psoriasis patients—beyond glycemic or weight outcomes—represents a novel avenue for clinical exploration. The study’s design, incorporating a real-world, large-scale dataset and rigorous statistical controls, lends weight to the observed associations, though causality cannot be definitively established in observational research.
Professor Ludwig’s team stresses that while the results are compelling, they should be interpreted with the study’s observational nature in mind. The researchers call for prospective randomized trials to confirm causality and to further delineate the mechanisms by which GLP-1RAs might influence mortality, cardiovascular risk, and behavioral health outcomes in psoriasis patients.
Biological Mechanisms and Hypotheses
The study authors propose that GLP-1 receptor agonists may exert protective effects in psoriasis through mechanisms that extend beyond their primary therapeutic targets of weight reduction and glycemic control. One central hypothesis is that GLP-1 receptor activation may downregulate pro-inflammatory mediators that are characteristically elevated in psoriasis. By reducing systemic inflammation, GLP-1RAs could diminish the inflammatory milieu that contributes to cardiovascular risk and potentially influence other organ systems implicated in comorbid conditions.
Additionally, the presence of GLP-1 receptors in brain regions associated with mood regulation and reward processing offers a plausible link to the observed reductions in alcohol and substance use. The neural expression of GLP-1 receptors has been implicated in appetite and reward pathways, and this study’s findings align with the notion that receptor activation could yield psychiatric and behavioral benefits in susceptible individuals.
The researchers emphasize the possibility of a synergistic interaction between systemic inflammation—an intrinsic feature of psoriasis—and GLP-1RA pharmacology. If the inflammatory background enhances susceptibility to cardiovascular disease or psychiatric comorbidity, then mitigating this inflammation with GLP-1RAs could translate into improved clinical outcomes beyond metabolic endpoints. While these mechanistic hypotheses are grounded in current biological understanding, they are exploratory in the context of this study and warrant further experimental validation.
It is important to recognize that the observed safety profile matched expectations based on broader population data for GLP-1RAs. The absence of a significant rise in adverse reactions such as hypoglycemia, nausea, or constipation within this psoriasis cohort supports the feasibility of GLP-1RAs as a safe therapeutic option in a population with complex comorbidity.
Safety Profile, Tolerability, and Clinical Implications
The study reports that the safety outcomes among psoriasis patients treated with GLP-1RAs did not differ meaningfully from those observed in the general population treated with these agents. There was no notable increase in hypoglycemia, gastrointestinal side effects, or other common adverse events that would raise concerns about tolerability in this special patient group.
From a clinical standpoint, these safety signals—coupled with the observed reductions in mortality, cardiovascular risk, and behavioral health issues—support considering GLP-1RA therapy as a potentially attractive option for psoriasis patients who also require diabetes or weight management treatment. The data suggest that GLP-1RAs may deliver dual benefits in a single therapeutic approach, addressing metabolic health while potentially mitigating cardiovascular and psychiatric risks linked to psoriasis and its comorbidities.
The study’s senior author underscores the importance of balancing the promising efficacy signals with the need for individualized patient assessment. Clinicians should evaluate cardiovascular risk, liver and kidney function, coexisting conditions, and potential contraindications before initiating GLP-1RA therapy in psoriasis patients. The expanding evidence base invites a more nuanced conversation about personalized medicine, where psoriasis treatment choices are informed not only by skin-specific outcomes but also by systemic health considerations.
As the medical community absorbs these findings, it will be essential to monitor ongoing research, including randomized trials and real-world studies, to verify causality, explore long-term outcomes, and refine patient selection criteria. If subsequent studies corroborate these results, GLP-1RAs could become a more central component of a comprehensive care strategy for psoriasis patients facing metabolic challenges and cardiovascular risk.
Comparison with Other Treatments and Potential Synergy
The observed advantages of GLP-1RA therapy in psoriasis patients, particularly when contrasted with other diabetes or obesity medications, point toward potential advantages beyond weight and glycemic control. The relative reductions in mortality and major cardiovascular events suggest that GLP-1RAs may influence pathways involved in systemic inflammation, endothelial function, and metabolic stress, which collectively contribute to cardiovascular risk.
This potential synergy is especially relevant for patients who bear a dual burden of psoriasis and metabolic disease. The therapy could address both disease categories with a single pharmacologic approach, simplifying regimens and potentially improving adherence. However, it remains essential to consider each patient’s unique clinical picture, including comorbidities, existing treatments, and risk factors, to determine where GLP-1RAs fit within a broader treatment plan.
From a research perspective, these findings encourage further exploration of how GLP-1RAs interact with inflammatory pathways characteristic of psoriasis. If confirmed, this could prompt the development of psoriasis-specific guidelines regarding the use of GLP-1RAs in patients with concurrent metabolic disorders, and it could stimulate innovation in drug development to optimize anti-inflammatory and metabolic effects in this patient population.
Limitations and Future Research
While the study presents compelling associations between GLP-1RA use and favorable outcomes in psoriasis patients with diabetes or obesity, it is essential to acknowledge limitations inherent to observational research. The use of a large database and propensity score matching strengthens the robustness of the findings, yet residual confounding cannot be entirely ruled out. Differences in unmeasured variables—such as disease severity, socioeconomic factors, access to care, lifestyle choices, and adherence patterns—could influence outcomes.
The two-year observation window provides valuable short-to medium-term insights but does not illuminate long-term effects or durability of benefits beyond this period. Additionally, while the results held across multiple sensitivity analyses, the observational design cannot establish causality. These findings should be considered hypothesis-generating and should spur prospective randomized trials to confirm whether GLP-1RAs directly reduce mortality and cardiovascular risk in this specific patient population.
Future research should aim to:
- Replicate findings in diverse populations and healthcare settings to assess generalizability.
- Conduct randomized controlled trials to establish causality and quantify the magnitude of benefit.
- Investigate the mechanistic underpinnings of the anti-inflammatory and neurobehavioral effects linked to GLP-1RA therapy in psoriasis.
- Explore optimal patient selection criteria, dosing strategies, and combination regimens that maximize benefit while maintaining safety.
- Assess long-term outcomes, including the durability of cardiovascular and psychiatric benefits and potential effects on psoriasis severity itself.
Such studies would provide clearer guidance for clinicians considering GLP-1RAs as part of a multifaceted treatment strategy for psoriasis patients with coexisting metabolic disease, helping to define where these agents fit within standard-of-care pathways.
Practical Takeaways for Clinicians and Patients
- GLP-1 receptor agonists may represent a promising option for psoriasis patients who also require treatment for diabetes or obesity, offering potential benefits beyond weight loss and glucose control.
- Clinicians should consider individual patient risk profiles, including cardiovascular risk, mental health status, and potential contraindications, when evaluating GLP-1RAs as part of a comprehensive treatment plan.
- The observed reductions in alcohol and substance use risk highlight a potential ancillary benefit that may be particularly relevant for patients with psoriasis who experience psychiatric comorbidities or risky behavioral patterns.
- Safety signals in the psoriasis cohort aligned with expectations from broader GLP-1RA data, suggesting these agents can be used with careful monitoring in appropriately selected patients.
- Given the observational nature of the current evidence, GLP-1RAs should be incorporated into practice with cautious optimism, pending confirmation from randomized trials and longer-term studies.
Clinicians who manage psoriasis patients with obesity or diabetes may find it valuable to stay abreast of emerging evidence on GLP-1RAs, including potential guidelines that address their use in psoriasis populations. Patients should engage in shared decision-making with their healthcare teams, weighing the potential cardiovascular, metabolic, and behavioral health benefits against possible risks and personal treatment goals.
Public Health and Global Implications
If the benefits observed in this study are confirmed through future research, GLP-1 receptor agonists could influence broader public health strategies for managing psoriasis in populations with high rates of obesity and diabetes. Reductions in cardiovascular events and mortality could translate into meaningful decreases in healthcare burden and improve quality of life for millions of individuals affected by psoriasis and metabolic comorbidities worldwide. In addition, improvements in behavioral health outcomes such as reduced alcohol and substance use could have positive downstream effects on social functioning, productivity, and overall well-being.
As healthcare systems grapple with rising rates of obesity and diabetes, therapies that address both metabolic health and inflammatory skin disease may offer a more integrated approach to patient care. The potential to streamline treatment regimens, improve adherence, and generate dual- or multi-system benefits would be particularly valuable in real-world settings where comorbidity complicates management and outcomes.
Conclusion
The latest findings presented at the EADV 2025 congress illuminate a compelling association between GLP-1 receptor agonist therapy and improved survival, cardiovascular outcomes, and behavioral health in psoriasis patients with diabetes or obesity. The study, which analyzed data from a vast U.S. health database and employed robust methods to control for confounding, identified substantial relative reductions in mortality (78%), major cardiovascular events (44%), alcohol abuse risk (65%), and substance use disorders (nearly 50%). The observed safety profile aligned with expectations for GLP-1RA therapy, bolstering the case for considering these agents in psoriasis patients who require metabolic health management.
While the observational design precludes definitive statements about causality, the consistency of the findings across sensitivity analyses and the biologically plausible mechanisms proposed by the researchers provide a strong rationale for further investigation. The authors emphasize the potential for GLP-1RAs to exert anti-inflammatory effects and to influence brain pathways related to mood and reward, offering a possible explanation for improved psychiatric and behavioral outcomes. The notion of synergy between systemic inflammation in psoriasis and GLP-1RA action invites a new line of inquiry into how metabolic and inflammatory processes intersect in this patient population.
Ultimately, these results suggest that GLP-1 receptor agonists may become a valuable addition to the therapeutic arsenal for psoriasis patients with diabetes or obesity, addressing not only metabolic health but also cardiovascular and behavioral health risks. Clinicians should follow ongoing research closely and consider individual patient contexts as they weigh the potential benefits and risks of GLP-1RA therapy in this complex, multi-morbidity setting. Continuous evaluation through randomized trials and long-term observational studies will be essential to translating these findings into concrete clinical practice guidelines and patient care strategies.