Association Between Dermatologic Diseases and Glucagon-Like Peptide-1 Receptor Agonist Among Patients with Type 2 Diabetes

Aim: The relationship between glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dermatologic autoimmune diseases remains uncertain. This study determined the incidence of dermatologic diseases among patients with type 2 diabetes (T2DM) receiving GLP-1 RAs. Methods: This retrospective cohort study used TriNetX US Network, including 746,261 adults with T2DM between January 1, 2018, and December 31, 2022. Patients were categorised based on the initiation of GLP-1 RAs or dipeptidyl peptidase-4 inhibitors (DPP-4is). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the incidence of dermatologic autoimmune outcomes. Results: After propensity score matching, each group included 169,630 well-balanced patients. GLP-1 RA use was associated with a modestly increased risk of psoriasis (HR 1.19, 95% CI 1.11-1.28) and a decreased risk of pemphigus (HR 0.32, 95% CI 0.16-0.63) and bullous pemphigoid (HR 0.61, 95% CI 0.43-0.87) compared with DPP-4i use. Other autoimmune skin conditions showed no difference. The sensitive test also showed a higher risk of psoriasis compared to most other antidiabetic medications. Further analysis suggested that patients with psoriasis may benefit clinically from GLP-1 RA therapy. Conclusion: GLP-1 RA use was associated with a modestly increased risk of psoriasis; however, patients with pre-existing psoriasis may nonetheless derive clinical benefits from this therapy.