Published in JAMA Dermatology, the analysis adds to growing evidence that GLP-1 receptor agonists may influence systemic inflammatory pathways in addition to improving metabolic health.

Reduced Mortality and Cardiovascular Events

Investigators analyzed data from the TriNetX clinical research network, identifying patients diagnosed with HS between January 2015 and March 2026. Individuals were classified as GLP-1 receptor agonist users if they had received at least two prescriptions for a medication in the class. After propensity-score matching, the final study population included 20,477 patients in both the treatment and control groups.

At one year of follow-up, GLP-1 receptor agonist use was associated with a 71% lower risk of all-cause mortality compared with nonuse (hazard ratio [HR] 0.29; 95% CI, 0.23–0.37). The reduction remained substantial at two years (HR 0.36; 95% CI, 0.30–0.43).

Major adverse cardiovascular events were also less common among GLP-1 users, with risk reductions observed at both one year (HR 0.70) and two years (HR 0.79).

Benefits Extend Beyond Cardiometabolic Outcomes

The study identified significant decreases in several additional clinical outcomes commonly associated with systemic inflammation.

Compared with nonusers, patients receiving GLP-1 receptor agonists demonstrated lower risks for:

• Cardiovascular procedures (HR 0.49 at one year; 0.58 at two years)
• Ischemic heart disease (HR 0.72; 0.79)
• Heart failure (HR 0.62; 0.74)
• Sepsis (HR 0.55; 0.70)
• Lymphedema (HR 0.67; 0.76)
• Cellulitis (HR 0.66; 0.73)

Stroke risk showed a favorable trend after one year and reached statistical significance after two years, with a 24% reduction in risk among GLP-1 users.

Sensitivity analyses excluding early events and restricting the dataset to more recent years produced findings consistent with the primary analysis. Researchers also reported similar benefits among patients without diabetes. Results in patients without obesity followed the same pattern, although they did not achieve statistical significance.

Why GLP-1 Therapies May Be Relevant in HS

HS is a chronic inflammatory skin disorder associated with increased rates of cardiovascular disease and premature mortality. Many patients also have obesity, insulin resistance, dyslipidemia, fatty liver disease, obstructive sleep apnea, and other conditions that contribute to systemic inflammation and elevated cardiovascular risk.

Because GLP-1 receptor agonists have demonstrated anti-inflammatory, weight-reducing, and cardiometabolic benefits in other populations, researchers hypothesized that these agents could provide advantages for patients with HS as well.

An accompanying editorial noted that the overlap between metabolic dysfunction and immune activation in HS provides a strong biological rationale for further investigation of GLP-1 therapies in this patient population.

Observational Findings Require Confirmation

Despite the encouraging results, the authors emphasized that the study was observational and cannot establish a causal relationship between GLP-1 receptor agonist use and improved outcomes. Although patients were carefully matched for baseline characteristics and comorbidities, the possibility of residual confounding remains.

The investigators concluded that GLP-1 receptor agonists may represent a promising adjunctive strategy for reducing the overall systemic burden of disease in HS. However, they stressed that prospective clinical trials with longer follow-up are needed to determine whether the observed associations translate into confirmed therapeutic benefits.

If validated in future studies, GLP-1 receptor agonists could emerge as an important component of comprehensive HS management, potentially addressing both cardiometabolic risk and inflammation-related complications.