When obesity and psoriatic diseases were treated concomitantly with a biologic and a GLP-1 receptor agonist (RA), more than 90% of patients reported satisfaction with their treatment, in a newly completed real-world study. 

The high rate of patient satisfaction was based on a cross-sectional survey, not a placebo-controlled assessment, so drug interactions for quality of life measures could not be measured, but patient satisfaction was high, according to a collaborating group of dermatologists and rheumatologists that included April Armstrong, MD, professor and chief of dermatology at the University of California, Los Angeles.

In the study population of 174 patients who had psoriasis and/or psoriatic arthritis (PsA) and obesity or overweight, “findings show that participants experienced high control of their psoriatic disease and a low impact of psoriatic disease on their quality of life at the time of the survey,” Armstrong and her co-investigators reported in a poster presented at Maui Derm Hawaii 2026. 

Tirzepatide Used Alongside IL-17 Inhibitor 

The two treatments in the study were the anti-interleukin 17 (anti-IL-17) monoclonal antibody ixekizumab and the GLP-1 RA tirzepatide. All 174 patients participating in the survey had enrolled in a support program created by the manufacturer of both agents (Eli Lilly) to create prescription savings.

Showing the compatibility of treatments in these two classes is important, because “obesity is linked with increased severity and risk for developing psoriatic disease based on shared underlying mechanisms of chronic inflammation,” the authors reported. 

Guidelines from multiple organizations, including the American Academy of Dermatology and the American College of Rheumatology call for simultaneous treatment of both conditions when they coexist, according to the authors. 

Good control of the target conditions with each therapy were credited with high rates of patient satisfaction for both treatments. When considered alone, fewer than 2% were neutral or dissatisfied. When considered together, 92.5% reported being very satisfied or somewhat satisfied with treatment with both.

Of those surveyed, 14% had plaque psoriasis only, 24% had PsA only, and the remainder had both. The IL-17 inhibitor had been prescribed by a rheumatologist in 61% of cases and by a dermatologist in almost all others. In contrast, tirzepatide was prescribed by a rheumatologist in 29% of cases, a dermatologist in 10% of cases, and a primary care provider for the remainder.

Weight loss was greater than 5% in more than 85% of the patients and greater than 10% in about 71%. Nearly half (47%) achieved a weight loss greater than 15%. In all patients, the weight-loss drug was started after initiation of the anti-IL-17 therapy. Responses from the survey suggested an added effect of the weight loss drug on their autoimmune disease.

Of the 174 patients, 128 (73.6%) who reported improvement in weight also reported an improvement in psoriasis and/or PsA since starting tirzepatide, according to the research group.

First Study to Evaluate Anti-IL-17 Plus GLP-1 Agonist 

Characterized as the first study to examine the experience of taking concomitant ixekizumab and tirzepatide in patients with psoriatic disease, patient satisfaction was evaluated on a 5-point Likert scale ranging from very dissatisfied to very satisfied. Disease severity was evaluated with patient global assessments and patient global impression of change. Quality of life was measured with validated scales including the Dermatology Life Quality Index.

The mean time since diagnosis was 12 years for those with psoriasis and 6 years for those with PsA. At the time of the survey, 84% had been on ixekizumab and 63% on tirzepatide for at least 6 months. More than 60% had been on both therapies for at least 6 months.

From the survey data, which were not validated in a clinic, it is not possible to determine whether the two treatments performed as well or better when used concomitantly than when used alone, the investigators acknowledged. However, the study reinforces other evidence that the drugs improve quality of life in a real-world setting, they wrote.

The association between obesity and psoriasis has long been recognized. In a 2016 review paper, obesity was identified as a risk factor for developing psoriasis and aggravating psoriasis. The same article review referred to evidence that weight reduction can reduce the severity of psoriasis in overweight individuals, and both conditions are pro-inflammatory and might exacerbate the cardiovascular risk associated with each.

In a more recent guideline summary of the role of GLP-1 RAs posted online by the International Psoriasis Council, the ability of GLP-1 RAs — specifically, not just weight loss — was linked to improvement in psoriasis symptoms. Although the author, Allison K. Truong, MD, a dermatologist affiliated with Cedars-Sinai Medical Center, Los Angeles, wrote that definitive trials are needed to confirm a direct benefit, she reported that there is solid evidence to link obesity to greater psoriatic disease activity and to connect weight loss to improved psoriasis outcomes.

In her summary, Truong also emphasizes the role of adipocytes in systemic inflammation, a variable fundamental to both disease activity and risk to other organ systems, particularly the cardiovascular tree. She noted that obesity and psoriasis share similar inflammatory profiles.

The study was supported by Eli Lilly. Armstrong reported financial relationships with AbbVie, Arcutis, Boehringer Ingelheim, Bristol-Myers Squibb, Dermavent, Janssen, Lilly, Leo, Novartis, Ortho, Pfizer, Regeneron, Sanofi, Sun, and Takeda. Several authors are Eli Lilly employees. Truong reported no potential conflicts of interest.