GLP-1 drugs and hidradenitis suppurativa

A nationwide Danish cohort study found that people with hidradenitis suppurativa, often shortened to HS, started glucagon-like peptide-1 receptor agonists more often and earlier than matched people with psoriasis or people from the general population. The study did not show that these medicines directly improved HS. That comparison is central. Reductions in surgery and HS treatment use after initiation were also seen in matched people who did not start a GLP-1 medicine^[1].

GLP-1 receptor agonists are medicines used for conditions such as type 2 diabetes and chronic weight management. Semaglutide is one example in this class. For a reader with HS, this paper is useful because it describes who is receiving these medicines in routine care. It is not evidence that a GLP-1 medicine is an HS treatment.^[1]

What the Danish cohort found

The researchers used nationwide Danish health registers covering 2000 through 2022. They identified 12,581 adults with HS, then compared them with 9,824 people with psoriasis and 12,581 background controls matched by age and sex. During follow-up, 8.2% of people with HS initiated a GLP-1 receptor agonist. The corresponding proportions were 5.7% among people with psoriasis and 3.2% among controls.^[1]

The average time to initiation was 8.88 years after the HS index date, compared with 10.1 years for psoriasis and 10.2 years for controls. The difference may reflect the metabolic burden documented in the HS group, rather than a decision to treat skin inflammation with a GLP-1 medicine. The study reports that cardiometabolic and psychiatric comorbidities increased between diagnosis and treatment initiation across the comparison groups.^[1]

That context matters when readers encounter claims about semaglutide or other GLP-1 medicines for HS. A cohort can show patterns of care and associations. It cannot, by itself, establish that a medicine caused a change in disease activity.^[1]

Why HS and GLP-1 medicines appear in the same study

HS is a chronic inflammatory skin disease that can involve painful lumps and draining tunnels, commonly in the armpits, groin, or buttocks. The study background describes HS as associated with obesity, metabolic dysfunction, and greater healthcare use. Those overlapping health needs help explain why GLP-1 receptor agonists may appear more often in an HS population.^[1]

A GLP-1 receptor agonist works by activating the same receptor as the gut hormone GLP-1. The medicines are prescribed within their authorised indications, not because a cohort paper suggests a new use. Our semaglutide guide explains the class and its established uses. Individual suitability, risks, and prescribing decisions require a clinician who knows the person's medical history.^[1]

The lower treatment use does not prove an HS benefit

Among people with HS who received continuous GLP-1 treatment, the researchers observed lower rates of surgical procedures and systemic medication use in the two years after initiation. That finding could sound like proof of an HS benefit at first glance. The comparison result is the important qualifier: matched HS non-users showed comparable declines, and the differences between groups were not statistically significant.^[1]

The authors therefore call for further research to determine whether GLP-1 receptor agonists directly improve HS disease activity. This is an observational register study, not a randomised trial assigning people to a GLP-1 medicine or placebo. It cannot separate a drug effect from changes in clinical care, weight, other treatment choices, or the natural course of symptoms.^[2]

The paper also does not identify one GLP-1 drug as an HS option, establish an HS dose, or replace standard dermatology care. A semaglutide overview can help readers distinguish approved uses from research questions, but it cannot answer whether a GLP-1 medicine will change one person's HS.^[1]

What this paper can and cannot tell readers

This large real-world study describes GLP-1 receptor agonist use among Danish adults with HS. The HS group had more frequent and earlier treatment initiation than the two comparison groups. By the time treatment began, comorbidity burden was substantial.^[1]

No individual treatment plan follows from it. Nor can it establish that GLP-1 treatment reduces HS flares, pain, drainage, or surgery. The study cannot determine whether an apparent change after initiation came from the medicine itself. Controlled studies and individual clinical assessment are needed for those questions.^[1]

What we do not yet know

The next useful evidence would compare clearly defined HS outcomes in groups assigned to treatment under a protocol. Until then, this cohort should be read as a signal about care patterns and comorbidity, not as proof of a new dermatology indication. If you have HS and are considering a GLP-1 medicine for an established indication, discuss the full picture with a qualified healthcare professional, including current HS treatment and other conditions.^[1]

Readers looking for background on the medicine class can review our semaglutide resource. Keep the two questions separate: what a GLP-1 medicine is approved to treat, and what research has actually established for HS.^[1]