Glucagon-like peptide-1 agonists as an adjunctive treatment for hidradenitis suppurativa: A quality improvement initiative by international dermatology outcome measures (IDEOM)

Summary: Abstract Body: This clinic-based quality improvement project aims to assess the effect of glucagon-like peptide-1 (GLP-1) agonists on hidradenitis suppurativa (HS) patient outcomes. Because GLP-1 agonists can reduce systemic inflammation, we hypothesize that their use in HS patients with comorbid diabetes and/or obesity may reduce HS disease severity. Clinical and laboratory assessments were obtained at every patient visit, including vitals, weight, Numeric Rating Scale (NRS) pain score, physical exam, and metabolic parameters. Additionally, patients completed the IDEOM Musculoskeletal Questionnaire (MSK-Q), a 9-item tool validated in psoriasis and exploratory in HS that assesses MSK symptom severity, impact, and fatigue over the past week. The mean age of our 25-patient cohort was 36.4 +/- 13.8; 48.0% African American, 28.0% other, 16.0% white, and 8.0% Asian. Average baseline BMI was 39.6 +/- 7.2, average hemoglobin A1C (HbA1C) was 5.9 +/- 0.5; 24.0% of patients had diagnosed pre-diabetes and 12.0% had diagnosed diabetes. Average responses to the IDEOM MSK-Q showed that MSK symptoms had the greatest impact on daily physical activities (mean impact rating 5.8 +/- 3.5). Due to challenges with insurance approval, only 44.0% of patients received the prescribed GLP-1 agonist. Of these patients, 54.5% had at least one follow-up visit after beginning the medication. Average weight loss was 20 pounds over 19.5 +/- 15.7 weeks. Upon comparing baseline to most recent follow-up visit, three patients achieved HS clinical response (HiSCR). Notably, the mean change from baseline visit to most recent follow-up visit decreased in most questions listed in the IDEOM MSK-Q, abscess and nodule count, NRS pain score, total cholesterol, lipoprotein A, apolipoprotein B, and HbA1C. While our study is ongoing, preliminary data support the use of GLP-1 agonists as an adjunctive HS therapy. Sarah Romanelli¹, Gretchen D. Ball¹, Zachary Levy¹, Mark Taliercio¹, Hassan Hamade¹, Joseph Merola², Alice B. Gottlieb¹ 1. Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States. 2. Dermatology, The University of Texas Southwestern Medical Center, Dallas, TX, United States. Clinical Research: Interventional Research