# Do GLP-1 Drugs Help Hidradenitis Suppurativa? Twenty People, No Control Group Do GLP-1 drugs help hidradenitis suppurativa? A 20-patient open-label study, a matched cohort reporting a mortality hazard ratio of 0.24, and what neither design can establish. Publisher: This GLP Editorial Team Canonical: https://thisglp.com/research/do-glp1-drugs-help-hidradenitis-suppurativa Updated: 2026-09-17 Published: 2026-09-16 [← Research](https://thisglp.com/research) Evidence # Do GLP-1 Drugs Help Hidradenitis Suppurativa? Twenty People, No Control Group A small study reported that semaglutide improved every outcome it measured in a painful skin disease. Reading why that is not yet a finding is a skill worth having. [This GLP Editorial Team](https://thisglp.com/about)September 20269 min readUpdated September 2026 Where a claim can come from · case reports · a few patients, no design · single-arm cohort · everyone gets the drug · controlled trial · a group that does not · replication · somebody else finds it too **Research, not medical advice.** This GLP is independent and educational. Nothing here is a substitute for individualized care from a licensed clinician, and reading it creates no doctor–patient relationship. Talk to your own provider before starting, stopping, or changing any medication, peptide, or therapy. See our [methodology](https://thisglp.com/methodology) and [terms](https://thisglp.com/terms). One 20-person study says yes and cannot prove it. Over six months on semaglutide above 1 mg a week, body weight fell 21.4 kg and Hurley stage improved in every single patient [\[1\]](https://thisglp.com/research/do-glp1-drugs-help-hidradenitis-suppurativa#ref-1). The dermatology quality-of-life index improved 8.8 points, a pain scale 4.1 and a depression inventory 12.9, all at p<0.001. There was no control group and no blinding, so none of it separates the drug from six months of attention in a relapsing disease. A separate matched-record cohort in the same condition reports an all-cause mortality hazard ratio of 0.24 (95% CI 0.145 to 0.395), which is roughly four times the effect randomized trials of this class produce [\[2\]](https://thisglp.com/research/do-glp1-drugs-help-hidradenitis-suppurativa#ref-2). ## Key takeaways - A six-month study of semaglutide in hidradenitis suppurativa reported large improvements in every outcome it measured. - It enrolled 20 adults, was open-label, and had no control group. Everyone received the drug and everyone knew it. - Weight fell 21.4 kg. Quality-of-life score improved 8.8 points, pain 4.1 points, and a depression score 12.9 points, all at p<0.001. - The authors report that several improvements held after adjusting for weight change — a calculation a single-arm study cannot support. - None of this is a reason to dismiss the finding. It is a reason to know what grade of finding it is. Every few weeks another condition joins the list of things these drugs are said to help. Some of those claims will turn out to be right — the [knee osteoarthritis result](https://thisglp.com/research/do-glp1-drugs-help-knee-pain) came out of a randomized trial of 407 people. The useful question is not which claims sound plausible but what kind of study produced them, and there is a small study of a painful skin disease that makes an unusually clean example of the problem. ## The study Hidradenitis suppurativa is a chronic inflammatory skin condition, strongly associated with obesity, that produces recurrent painful lesions. A prospective open-label cohort followed 20 adults with the condition and obesity for six months on semaglutide above 1 mg a week [\[1\]](https://thisglp.com/research/do-glp1-drugs-help-hidradenitis-suppurativa#ref-1). It measured weight, body composition, skin severity, pain, mood, and metabolic and inflammatory markers at baseline and at the end. The results are striking: body weight fell 21.4 kg, and Hurley stage, the standard severity grading, decreased in every single patient. The dermatology quality-of-life index improved by 8.8 points, a pain visual analog scale by 4.1, and a depression inventory by 12.9, all at p<0.001. Blood pressure, waist circumference and fat measures all fell as well. If you read only that paragraph you would conclude the drug treats the disease. ## What is missing There was no control group: every participant got semaglutide, and each one’s six-month numbers were compared with their own baseline numbers. That design cannot separate the drug from everything else that happens in six months, including regression to the mean in a relapsing-remitting disease and the attention of a research team. Seasonal variation, other treatments and the simple fact that people enroll in studies when their condition is bad all sit inside the same window. It was also open-label, so participants knew they were taking the drug. Three of the four headline outcomes — quality of life, pain, and mood — are self-reported, which is where that matters most. A person who has lost 21 kg and knows why will answer a pain questionnaire differently. And there were 20 people, not 20 per arm but twenty in total, which is roughly the size at which a single unusual responder moves a mean. None of this is misconduct; it is what a pilot study is. The paper is honest about its design in its own methods section. The adjustment that cannot work The authors report that after adjusting for weight change, improvements in quality of life, pain, depressive symptoms, skin severity and several markers remained significant. That sentence will be quoted as evidence of a weight-independent anti-inflammatory effect, and it cannot be. In a single-arm study, there is no group that took the drug without losing weight, and no group that lost weight without the drug. A statistical adjustment cannot manufacture the comparison the design omitted. ## The record-linkage studies, and why their numbers are too large Two large matched cohorts sit beside the pilot and point the same way with implausible force. The hidradenitis cohort puts all-cause mortality at a hazard ratio of 0.24 over two years, while reporting hyperlipidemia at 1.25, fatty liver disease at 1.37 and nausea at 1.31 in the same table [\[2\]](https://thisglp.com/research/do-glp1-drugs-help-hidradenitis-suppurativa#ref-2). Exposure required at least a year of therapy, so nobody who died inside that year could be counted as exposed. A 6,096-person matched cohort in psoriasis reports lower mortality and cardiac events at effect sizes no trial has produced [\[3\]](https://thisglp.com/research/do-glp1-drugs-help-hidradenitis-suppurativa#ref-3). Three quarters of deaths not happening is what confounding looks like, and the full reading of that figure is in [a hazard ratio of 0.24](https://thisglp.com/research/glp1-mortality-in-hidradenitis). ## Why this shape of claim keeps appearing Because it is cheap to produce and genuinely interesting. Twenty patients, six months, no randomization and no placebo is a study a single clinic can run. It is the correct first step, and the correct thing to do with its result is to design the trial that would test it. The failure is downstream, when the pilot gets summarized as a finding and the finding gets summarized as an indication. There is a legitimate version of the weight-independent claim, and it looks different. A prespecified analysis of 1,145 randomized participants [found symptom benefit and weight loss moving apart](https://thisglp.com/research/glp1-heart-failure-frailty) inside a controlled trial, which is the kind of comparison that can support the inference. Same shape of conclusion, completely different grade of evidence. ## How to read the next one Three questions settle most of it: was there a group that did not get the drug, did anyone not know what they were taking, and how many people in total rather than per headline. Those take ten seconds against an abstract and they sort nearly every claim you will meet. Effect sizes and intervals matter too, and [what a comparator can tell you](https://thisglp.com/research/do-glp1-drugs-cause-gout) is the longer version of the first question. Nobody on this roster sells semaglutide for hidradenitis suppurativa, and no seller claims it. What sellers do carry is a general implication that the benefits keep extending outward, which is where a twenty-person pilot ends up doing commercial work it was never built for. The ordinary weight-loss evidence is strong and [worth reading on its own terms](https://thisglp.com/research/semaglutide-cochrane-review). It does not need help from studies like this one, and [what a seller declines to say](https://thisglp.com/tools/questions-they-leave-open) is usually more informative than what it implies. ## Frequently asked Does semaglutide treat hidradenitis suppurativa? Unknown. One open-label study of 20 people reported large improvements over six months, but with no control group it cannot separate the drug from time, attention and regression to the mean. Were the improvements real? The measurements were real. Weight fell 21.4 kg and severity grading improved in every patient. Whether the drug caused the skin improvement is the part the design cannot answer. What about the weight-adjusted analysis? It is the weakest claim in the paper. Adjusting for weight change in a single-arm study cannot isolate a weight-independent effect, because no participant took the drug without losing weight. What would settle it? A randomized controlled trial with a group that does not receive the drug, ideally blinded, and large enough that one unusual responder cannot move the result. ## Sources 1. \[1\] Nicolau J, et al. (2026). Semaglutide in patients with hidradenitis suppurativa and obesity Medicina Clínica. [PMID 41832804](https://pubmed.ncbi.nlm.nih.gov/41832804/) 2. \[2\] Brouer IC, et al. (2026). Glucagon-like peptide-1 receptor agonists and tirzepatide are associated with reduced mortality, cardiovascular, and psychiatric risks in patients with hidradenitis suppurativa and type 2 diabetes and/or obesity: a retrospective cohort study Frontiers in Medicine. [PMID 42741157](https://pubmed.ncbi.nlm.nih.gov/42741157/) 3. \[3\] Olbrich H, et al. (2026). Glucagon-like peptide-1 receptor agonists and reduced mortality, cardiovascular and psychiatric risks in patients with psoriasis: a large-scale cohort study British Journal of Dermatology. [PMID 40897378](https://pubmed.ncbi.nlm.nih.gov/40897378/) ## Where to get it ### Best GLP-1 injections Every injectable seller we can verify, with the price each one publishes and an honest read of what the trials measured. [Compare providers →](https://thisglp.com/best/compounded-semaglutide) ## More in Evidence - [ 150 minutes · Weekly activity goal · 2 days · Muscle strengthening · Adapt · Symptoms and ability ### Exercise on Ozempic: Building Strength Without Ignoring Symptoms ](https://thisglp.com/research/exercise-on-ozempic) - [ STEP 1, semaglutide 2.4 mg vs placebo, % change at 68 weeks · LDL cholesterol · −2.5% vs +1.3% · Total cholesterol · −3.3% vs +0.1% · HDL cholesterol · +5.2% vs +1.4% · Triglycerides · −21.9% vs −7.3% · Wegovy label, Table 13. Adults without diabetes. Ozempic doses are lower. ### Does Ozempic Lower Cholesterol? What the Lipid Results in the Trials Show ](https://thisglp.com/research/does-ozempic-lower-cholesterol) - [ Where the insulin reduction came from, units per day · week 4 · 13.4 total · week 26 · 21.9 · the drug itself · the weight loss · The drug’s own contribution barely moved: 11.1 then 11.4. · Everything added between weeks 4 and 26 came from weight. ### Does Semaglutide Help Type 1 Diabetes? What Two Small Trials Found ](https://thisglp.com/research/semaglutide-in-type-1-diabetes)