Introduction:

A chronic low-grade inflammation is a common cause associated with obesity and psoriasis. In patients with psoriasis, obesity influences worsening of plaques, reduced biological treatment efficacy, and increased cardiovascular risk. In a previous study, improvements in metabolic and dermatological parameters were observed with liraglutide treatment independent of weight loss.

Objective:

To assess the effect of semaglutide treatment in patients with psoriasis and obesity.

Methods:

• 41 patients (56.1% female; mean age 45.9 ± 15 years; psoriasis duration 18.2 ± 11.6 years) treated with semaglutide.
• Severity of psoriatic lesions were assessed by PASI (Psoriasis Area Severity Index), VAS (Visual Analogue Scale of Pain), VAS (Visual Analogue Scale of Pain), and DLQI (Dermatology Quality of Life Index); mood assessed by Beck Depression Inventory (BDI).
• Metabolic parameters measured at baseline and after 3 months.

Results:

• Significant reductions at 3 months in:
• BMI: 38.7 ± 6.4 kg/m² vs 34.1 ± 5.9 kg/m² (p<0.001)
• Waist circumference: 113.8 ± 12.7 cm to 105.6 ± 10.7 cm (p<0.001)
• Preperitoneal fat: 2 ± 0.9 cm to 1.4 ± 0.8 cm (p<0.0001)
• Significant improvement in psoriasis, severity and quality of life:
• PASI: 11.3 ± 7.1 to 5.5 ± 5.1 (p<0.0001)
• VAS: 5 ± 1.7 to 2.3 ± 1.2 (p<0.0001)
• DLQI: 12.3 ± 7.4 to 5 ± 4.2 (p<0.0001)
• Metabolic and inflammatory markers reduced significantly:
• HbA1c (5.6±0.5% vs. 5.4±0.6%; p<0.0001), insulin (21.5±13.9 µIU/mL vs 14.8±12.3µIU/mL; p<0.001), ultrasensitive CRP (3.8±2.6mg/L vs 1.9±2.2mg/L; p<0.0001), ferritin (171.3±119.5ng/mL vs 120.9 ±115.5ng/mL; p=0.04), plasma cortisol (13±3.9 vs 11.2±2µg/dL, p=0.008).
• Depression scores decreased significantly (BDI: 15.1 ± 5.1 vs 9.4 ± 3.1; p<0.0001).
• Weight loss did not correlate with inflammatory markers or PASI improvement.
• No treatment discontinuations due to adverse effects.

Conclusions:

Semaglutide has been shown to be effective and safe in patients with psoriasis and obesity. There could be an anti-inflammatory effect that improves psoriatic lesions independent of weight loss.

ECO, 11-14 May 2025, Malaga, Spain