Although incomplete, the evidence is now sufficient to support “consideration” of adjunctive GLP-1 receptor agonists (RAs) in the treatment of patients with psoriasis and comorbid metabolic disorders, according to a newly published “Special Communication” from the National Psoriasis Foundation (NPF) medical board.

“Clinical evidence demonstrates improvements [with GLP-1 RAs] in skin severity, quality of life, and systemic inflammation mediated by both weight-dependent and independent mechanisms,” the authors concluded. They described their safety profiles as “generally favorable, with mostly mild gastrointestinal adverse effects.”

The supportive evidence is largely limited at this time to patients who are already candidates for GLP-1 RAs, such as those with obesity, diabetes, and cardiovascular risk factors driven by metabolic comorbidities. This is consistent with the interaction between excess weight and psoriasis pathology.

“For many years, we have suspected that one of the ways clinicians can optimize modern psoriasis therapy is through weight management,” Guy Eakin, PhD, NPF chief science and medical officer, said in a press release issued by the NPF.

GLP-1 RAs Are ‘Potentially Life-Changing’ for Psoriasis

“These new GLP-1 RA medications suggest a tremendous and potentially life-changing opportunity to patients,” he added, using GLP-1 RAs to refer to drugs that have an agonist effect on GLP-1 receptors alone or also act on receptors of glucose-dependent insulinotropic polypeptide (GIP), another incretin mimetic.

The Special Communication was published online on April 29, 2026, in JAMA Dermatology.

The therapeutic effect of GLP-1 RAs in people with psoriasis has been variable but substantial across studies reviewed for this NPF statement. When limited to those studies with “adequately sized cohorts,” the Psoriasis Area and Severity Index (PASI) is typically reduced by about 50%, according to data cited in the Special Communication.

The effect of GLP-1 RAs was not evaluated in patients in the absence of metabolic comorbidities, whether or not they were weight-related. Rather, the “ideal candidates” are specified as having obesity-related moderate-to-severe psoriasis and seeking weight loss to address such metabolic-related comorbidities as diabetes, established cardiovascular disease, obstructive sleep apnea, chronic kidney disease, or other weight-related conditions, according to the document.

The authors of the statement, led by Samip Sheth, MD, a dermatology resident at the University of Minnesota in Minneapolis, explain that the benefit of GLP-1 RAs on psoriasis severity stems from activity other than weight loss, including an anti-inflammatory effect, but most studies have looked at additive effects.

“Early studies show improvements in both skin disease and metabolic health, suggesting GLP-1 therapies may be a practical, adjunctive option for patients with psoriasis and metabolic comorbidities, supporting a more integrated approach to care,” Sheth stated in the NPF press release.

GLP-1 RAs for Psoriasis Might Warrant Multidisciplinary Use

This means that GLP-1 therapies should be provided to patients either in the context of a multidisciplinary team managing both psoriasis and disturbed metabolism or, at least, by “dermatologists experienced in metabolic risk assessment,” the authors wrote in the review.

There have been no major pharmacologic interactions for GLP-1 RAs when used with commonly used systemic psoriasis therapies, including methotrexate, cyclosporine, and biologics, according to the statement.

When GLP-1 RAs are being considered in patients with psoriasis, a systematic approach is recommended by the NPF. This includes baseline measures of metabolic biomarkers, such as BMI, A1c, fasting glucose, and lipids, as well as measures of disease activity, joint involvement, and symptoms, such as pruritus. A baseline quality of life assessment, such as the Dermatology Life Quality Index, can also help track response to therapy.

The principle of treating coexisting conditions in the context of psoriasis is not a novel concept.

“We know how significantly cardiology comorbidities can affect patients living with psoriasis, and having these types of adjunctive therapies is so impactful,” Brittany Weber, MD, PhD, director of the Cardio-Rheumatology and Cardio-Dermatology Program at the University of Texas Southwestern Medical Center in Dallas, said in the NPF press release.

Based on the data reviewed for the NPF Special Communication, “improvements seen in patients with regard to systemic inflammation and comorbidities are promising and exciting,” she added.

GLP-1 RAs do not have an indication for psoriasis, “which may limit insurance coverage when prescribed solely for dermatologic benefit,” the authors noted. While weight loss may make it possible to reduce the dose of or discontinue expensive treatments, “formal cost-effectiveness analyses in psoriasis are lacking,” they added. 

GLP-1 RAs Might Make Antipsoriatic Drugs Work Better

In addition to the expected benefit of weight loss on the pathophysiology of psoriasis, the senior author of the Special Communication, Andrew Blauvelt, MD, adjunct professor of dermatology at the University of Maryland School of Medicine in Baltimore, and the principal of Blauvelt Consulting in Annapolis, Maryland, cited evidence that GLP-1 RAs make antipsoriatic therapies “work better.”

The best evidence for this can be drawn from the TOGETHER-PsO trial, whose results were released in February of this year, according to Blauvelt. In an interview with Medscape Medical News, he said the evidence is not definitive, but “more trials like TOGETHER-PsO are needed to show that concomitant use of GLP-1 RAs and primary antipsoriatic drugs are better than antipsoriatic drugs alone.”

In the multicenter TOGETHER-PsO trial, 276 patients with moderate-to-severe psoriasis and obesity or overweight were randomly assigned to treatment with the anti-interleukin-17A monoclonal antibody ixekizumab or to ixekizumab plus the dual GLP-1/GIP receptor agonist, tirzepatide.

Among key results, 27.1% of those receiving both therapies vs 5.8% of those receiving ixekizumab alone achieved a 10% weight loss and a 100% PASI score at 36 weeks, according to a press release from Lilly, the manufacturer of both ixekizumab and tirzepatide.

The language in the NPF Special Communication is cautious. Rather than an unrestricted endorsement of GLP-1 RAs for the treatment of psoriasis even in patients with overweight/obesity who are candidates for these drugs, the authors stated, “definitive conclusions await larger randomized trials.” 

However, Blauvelt pointed out that these therapies are attractive in patients who are overweight with psoriasis, even if their precise role is still being explored. Not limited to reductions in obesity and psoriasis, “improving obesity can improve overall health in many ways,” he said.

Eakin reported having a financial relationship with Eli Lilly. Weber reported having financial relationships with Bristol Myers Squibb and Novo Nordisk. Sheth reported having no potential conflicts of interest. Blauvelt reported having financial relationships with AbbVie, Amirall, Alumis, Amgen, AnaptysBio, Apogee, Arcutis, Incyte, Janssen, Leo, Eli Lilly, Novartis, Oruka, Pfizer, Regeneron, Sanofi, Sun Pharma, Takeda, and UCB. The full list of disclosures is available in the paper.