GLP-1 Agonists in Psoriatic Disease: Beyond Weight Loss to Cardiovascular and Inflammatory Benefit
At the 2026 Masterclasses in Dermatology Annual Meeting, Brittany Weber, MD, PhD, delivered a forward-looking session on glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and their evolving role in psoriatic disease. Her focus extended beyond weight loss, framing obesity as a multisystem inflammatory driver of cardiovascular and dermatologic risk.
Dr Weber opened with a case study of a 37-year-old man with plaque psoriasis (>10% body surface area), psoriatic arthritis (PsA), obesity (body mass index 32 kg/m²), dyslipidemia, and elevated triglycerides. Despite a “low” 10-year atherosclerotic cardiovascular disease (ASCVD) risk of 2.4%, his lifetime risk of cardiovascular events was 46%. The question, she asked: “What is his risk of a clinical cardiovascular event, and how does psoriasis impact this risk?”
Obesity is not cosmetic—it is inflammatory. Dr Weber emphasized that obesity is a “multisystem disease associated with many complications,” including coronary artery disease, chronic kidney disease, nonalcoholic fatty liver disease, and type 2 diabetes. Shared inflammatory pathways connect adiposity and psoriasis, reinforcing a bidirectional relationship between obesity and psoriatic disease.
A pooled analysis of 16 observational studies showed 66% higher odds of obesity among patients with psoriasis (OR 1.66; 95% CI:1.46-1.89), with stronger associations in more severe disease.
GLP-1 RAs, originally developed for type 2 diabetes, have reshaped cardiometabolic management. Cardiovascular outcome trials demonstrated that GLP-1 RAs reduced major adverse cardiovascular events by approximately 14% in patients with diabetes. Importantly, the SELECT trial extended these benefits to patients with overweight/obesity and established ASCVD without diabetes, showing a 20% reduction in cardiovascular death, myocardial infarction, or stroke.
Additional cardiometabolic improvements included reductions in waist circumference, systolic and diastolic blood pressure, hsCRP, LDL-C, and triglycerides. In patients with HFpEF and obesity, semaglutide improved symptoms (Kansas City Cardiomyopathy Questionnaire Clinical Summary Score +8.7 points), exercise capacity (+20.3 m on 6 Minute Walk Test), and weight (-13.3% vs -2.6% placebo).
Emerging data suggest dermatologic implications. Small studies indicate GLP-1 RAs may improve Psoriasis Area and Severity Index scores, likely through weight reduction and inflammation modulation. The Together-PsA study evaluated combination IL-17A inhibition plus GLP-1/glucose-dependent insulinotropic polypeptide therapy in PsA with overweight/obesity. At 36 weeks, 31.7% achieved both American College of Rheumatology 50 and ≥10% weight loss vs 0.8% on ixekizumab alone (P <.001).
Dr Weber offered practical prescribing pearls: “Start low and go slow!” Nausea is most common during the first 4 to 5 weeks and typically declines over time. Contraindications include history of pancreatitis, medullary thyroid cancer/MEN2, pregnancy, breastfeeding, and type 1 diabetes.
“GLP-1 RAs offer potential benefits in treating psoriasis, hidradenitis suppurativa, and other inflammatory skin diseases; the most likely mechanisms of benefit are weight loss and inflammation modulation,” she concluded. “GLP-1 RAs are now a part of guideline-directed medical therapy for cardiologists, including in patients without diabetes and ASCVD. While studies are still emerging, data in psoriasis and PsA suggest a positive impact on both skin disease, arthritis, and metabolic health.”
For more meeting coverage, visit the Masterclasses in Dermatology newsroom.
Reference
Weber B. GLP-1 and obesity in psoriatic disease. Presented at: Masterclasses in Dermatology; February 19–22, 2026; Sarasota, FL.
