GLP-1 Receptor Agonists for Hidradenitis Suppurativa: Emerging Role in Management

The talk reviewed the emerging use of GLP-1 receptor agonists in hidradenitis suppurativa (HS), explaining their established roles in diabetes and obesity and their possible added benefits through appetite suppression, weight loss, reduced inflammation, and improved wound healing. The speaker highlighted small studies showing that HS patients starting GLP-1 therapy often improved in disease metrics, even when BMI did not change much, suggesting benefits beyond weight loss alone. In clinical experience, these medications seemed especially helpful for mild HS and sometimes made severe disease easier to manage, often allowing control with topical therapy or less frequent antibiotics. The presentation emphasized that dermatologists can prescribe GLP-1s themselves if they screen for contraindications such as MEN syndromes, thyroid cancer history, pancreatitis, gallbladder disease, gastroparesis, severe renal impairment, and allergy. A major barrier is insurance approval, with obesity indications being easier than HS-specific use; the speaker described strategies such as completing required weight-loss programs, working with nutrition services or pharmacists, and maintaining therapy for patients who already benefited even if they no longer meet BMI criteria. Tirzepatide was presented as a preferred option because of greater weight-loss efficacy, with advice to titrate slowly, expect GI side effects, monitor nutritional status during rapid weight loss, and keep an eye on evolving Medicare coverage. Overall, the speaker argued that addressing obesity and metabolic comorbidities can improve HS care, boost patient confidence, and strengthen engagement, while noting that randomized trials and long-term safety data are still lacking.