Featured Student: Sundus Malik

Zenab Ayaz is a sixth year medical student at the University of Missouri-Kansas City. Her primary interests are in internal medicine, cardiology, endocrinology, and their intersections within clinical medicine. When out about in Kansas City, she enjoys sipping on london fogs, junk journaling, and spending time with her friends

Psoriasis is a chronic, autoimmune-mediated disease process in which the growth cycle of skin cells is accelerated to an abnormal degree. This results in the characteristic red plaques with silvery scales, although psoriasis can have varying presentations. Psoriasis can also impact the body in other clinically significant ways, including with regard to the cardiovascular system and metabolism. In recent years, small randomized trials and observational cohorts have suggested the possibility of clinical improvement in psoriasis after treatment with GLP-1 receptor agonists (GLP-1RAs). This 2026 review assesses the emerging role of GLP-1RAs in the management of psoriasis and its associated comorbidities, arguing that their relevance may be linked to the metabolic and inflammatory pathways these medications target. 

GLP-1RAs have become central in the management of type 2 diabetes mellitus with their metabolic effects, including increasing pancreatic secretion of insulin, decreasing secretion of glucagon, and delaying gastric emptying. This results in a promotion of weight loss, in addition to a reduction in cardiovascular risk. GLP-1RAs also demonstrate significant anti-inflammatory effects by inhibiting NF-κB, JNK, and NLRP3 pathways, lowering proinflammatory cytokines (TNFα, IL-1β, IL-6), and enhancing IL-10 signaling. These mechanisms are not only relevant to T2DM, but also have involvement in psoriasis. 

This review summarizes existing evidence suggesting that GLP-1RAs may demonstrate improvements in psoriasis severity. Across several small randomized controlled trials and observational studies, reductions in Psoriasis Area and Severity Index (PASI) scores ranged from 40-80%, with the strongest evidence in adequately sized cohorts demonstrating a 48-52% reduction. These effects were varied in patients depending on their baseline metabolic dysfunction, with more significant improvements noted in patients with glucose intolerance or other metabolic dysfunction. These findings suggested that there may be weight-independent immunomodulatory effects influenced by GLP-1RAs, including increases in iNKT cells, decreases in TNFα-producing monocytes and dermal γδ T cells, and reductions in IL-17 and IL-23 expression and epidermal thickness.

Unlike some psoriasis reviews focusing solely on outcomes as they relate to the skin, this review addresses psoriasis on a more systemic nature, including the cardiovascular, metabolic, renal, and hepatic effects that it tends to coexist with. Although these findings are encouraging, this review is limited by the lack of larger-scale clinical trials included within it. Many of the included studies contained a small number of patients, lacked proper control groups, or only followed the patients for a short duration. This limits the confidence in the findings of the review. In summary, this review posits that, based on existing literature, GLP-1RAs could be utilized as an adjunct in treatment plans in select patients with psoriasis. While the exact role of GLP-1RAs in psoriasis management has not yet been substantiated, there is clinical evidence exhibiting improvement in systemic inflammation modulated by weight-dependent and independent mechanisms. This leads to not only a decrease in the severity of skin lesions but also an improvement in patients’ quality of life. In the future, more randomized controlled trials on a larger scale in patients with and without metabolic comorbidities are necessary to fully establish the role of GLP-1RAs in psoriasis treatment.