# Do GLP-1 Drugs Help Psoriasis? Clear Skin in 40.6% Against 29.0% | This GLP Do GLP-1 drugs help psoriasis? A 274-patient phase 3b trial, a 6,096-person matched cohort, and the hidradenitis evidence | what each design can support. Publisher: This GLP Editorial Team Canonical: https://thisglp.com/research/do-glp1-drugs-help-psoriasis Updated: 2026-09-17 Published: 2026-09-17 [← Research](https://thisglp.com/research) Evidence # Do GLP-1 Drugs Help Psoriasis? Clear Skin in 40.6% Against 29.0% Added to a biologic in 274 randomized adults, tirzepatide raised complete skin clearance from 29.0% to 40.6%. The trial's headline number is twice that, and half of it was settled at randomization. [This GLP Editorial Team](https://thisglp.com/about)September 20269 min read At week 36 · + tirzepatide · alone · skin clear AND 10% lost · 27.1% · 5.8% · skin clear (PASI 100) · 40.6% · 29% · 10% or more lost · 69.2% · 9.1% · Only one arm received a weight-loss drug. **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). On the skin, modestly. A phase 3b trial randomized 274 adults with moderate to severe psoriasis and overweight or obesity. Complete skin clearance at week 36 was 40.6% on ixekizumab plus tirzepatide against 29.0% on the biologic alone [\[1\]](https://thisglp.com/research/do-glp1-drugs-help-psoriasis#ref-1). That is a risk difference of 11.6%, on a confidence interval running from 0.3% to 22.9%. The trial’s headline endpoint was much larger, and half of it was settled before anyone was treated. No trial has tested a GLP-1 drug on psoriasis without a biologic alongside it. ## Key takeaways - A phase 3b open-label trial randomized 274 adults with moderate to severe psoriasis and overweight or obesity to ixekizumab with or without tirzepatide. - The primary endpoint combined complete skin clearance with 10% weight loss: 27.1% vs 5.8% (risk difference 21.2%, 95% CI 12.8%-29.7%). - Only one arm got a weight drug, so half that composite was settled at randomization. - On skin alone, PASI 100 was 40.6% vs 29.0% — a risk difference of 11.6% with a confidence interval running from 0.3% to 22.9%. - A separate 6,096-person matched cohort reported lower mortality and cardiac events in psoriasis, at effect sizes no trial has produced. - Nobody has randomized a GLP-1 drug against placebo in psoriasis. Every figure here is either a combination or a matched record. Between 60% and 78% of people with psoriasis carry overweight or obesity, and weight worsens both the disease and the response to treatment. That relationship is what makes the trial below worth running, and it is also what makes its headline number hard to read. The [comorbidity load in psoriasis](https://thisglp.com/research/glp1-psoriasis-comorbidities) is counted separately. A phase 3b trial at 72 US sites tested treating both at once, randomizing 274 adults to the biologic ixekizumab with or without tirzepatide [\[1\]](https://thisglp.com/research/do-glp1-drugs-help-psoriasis#ref-1). The headline result is large. At week 36, 27.1% of the combination arm reached complete skin clearance and lost at least 10% of their weight. On the biologic alone it was 5.8%, a risk difference of 21.2% (95% CI 12.8%–29.7%). Half of that endpoint was decided before anyone was treated The primary outcome requires clear skin and 10% weight loss together. One arm received a drug that reliably produces 10% weight loss and the other did not — and indeed 69.2% against 9.1% hit the weight component. A composite that bundles a near-certainty with an open question will move, and the size of the movement says more about the design than about what tirzepatide does to psoriasis. The number that answers the actual question is the skin-only one. Complete clearance was 40.6% with tirzepatide against 29.0% without, a risk difference of 11.6% whose confidence interval runs from 0.3% to 22.9% (P = .04). The lower bound sits three tenths of a percent above zero. That is a positive result by convention and the most fragile figure in the trial. It is also the one a dermatologist weighing a second drug actually needs. Two design features deserve weight here. The trial was open-label, so everyone knew who was receiving what, and PASI scoring involves investigator judgment. That combination tends to favor the more intensively treated arm on a visually assessed endpoint. Gastrointestinal events were more frequent on the combination. The trial reports that as consistent with known safety profiles, and it is still a tolerability cost attached to the extra 11.6%. The same class of stomach complaints is described from the mechanism side in [nausea and appetite on one circuit](https://thisglp.com/research/why-do-glp1-drugs-cause-nausea). ## What the record-based cohort adds, and what it cannot A US database cohort matched 3,048 psoriasis patients on a GLP-1 drug against 3,048 taking other antidiabetic or antiobesity drugs and followed both for two years [\[2\]](https://thisglp.com/research/do-glp1-drugs-help-psoriasis#ref-2). All-cause mortality came out at a hazard ratio of 0.219 (95% CI 0.123 to 0.391) and major adverse cardiac events at 0.561 (95% CI 0.442 to 0.714). A hazard ratio of 0.219 describes a group dying at roughly a fifth the rate of its comparator. No randomized trial of this class has produced anything close to it. Neither arm measured whether anyone’s psoriasis improved. The full reading, including why the cardiac figure is easier to believe than the mortality one, is in [the psoriasis comorbidity cohort](https://thisglp.com/research/glp1-psoriasis-comorbidities). ## The adjacent skin disease, and the grade of its evidence Hidradenitis suppurativa is a different condition with the same obesity link, and it shows what this literature looks like without a randomized comparison. An open-label study of 20 adults on semaglutide for six months reported weight down 21.4 kg, quality of life up 8.8 points and pain down 4.1, all at p<0.001 [\[3\]](https://thisglp.com/research/do-glp1-drugs-help-psoriasis#ref-3). There was no control group and no blinding, and three of those four outcomes are self-reported. A separate matched-record cohort in the same disease reported all-cause mortality at a hazard ratio of 0.24 (95% CI 0.145 to 0.395). Exposure required at least a year of therapy [\[4\]](https://thisglp.com/research/do-glp1-drugs-help-psoriasis#ref-4). Anybody who died inside that year could not be counted as exposed. Both studies are set out in [the twenty-person pilot](https://thisglp.com/research/do-glp1-drugs-help-hidradenitis-suppurativa) and [the hidradenitis mortality cohort](https://thisglp.com/research/glp1-mortality-in-hidradenitis). ## What the trial does establish The two drugs can be given together for a year without a new safety signal emerging, in a population where doing so was previously untested at this scale. Whether the skin benefit is worth a second injection is a judgment the confidence interval leaves genuinely open. The broader pattern of these drugs producing modest effects across many separate conditions runs through [the heart failure evidence](https://thisglp.com/research/do-glp1-drugs-help-heart-failure) and [the carpal tunnel comparison](https://thisglp.com/research/do-glp1-drugs-help-carpal-tunnel-syndrome). No telehealth seller prescribes for psoriasis, and nothing here is a reason to start or stop a drug. The record cohort is useful for reading a marketing claim. The risk reductions were larger in the psoriasis group than in groups without it. That is the kind of subgroup finding a landing page quotes without its population attached. Before a first order, the more useful questions are about who is prescribing and what happens at a higher dose, and those are listed in [questions they leave open](https://thisglp.com/tools/questions-they-leave-open). ## Frequently asked Do GLP-1 drugs help psoriasis? Added to a biologic in a 274-patient trial, tirzepatide raised complete skin clearance from 29.0% to 40.6%, a risk difference of 11.6% on an interval from 0.3% to 22.9%. No trial has tested one without a biologic alongside it. Why is the trial's headline number so much bigger? The primary endpoint required clear skin and 10% weight loss together. Only one arm received a drug that reliably produces 10% weight loss, so half the composite was settled at randomization. What about the cohort study reporting much lower mortality? A 6,096-person matched cohort reported all-cause mortality at a hazard ratio of 0.219. No randomized trial of this class has produced anything close to that, and neither arm measured whether psoriasis improved. Is there evidence in hidradenitis suppurativa? Only weak evidence. A twenty-person open-label study with no control group reported large improvements, and a matched-record cohort reported mortality at 0.24 under an exposure definition that excluded anyone who died inside the first year. Can I buy a GLP-1 for psoriasis? No telehealth seller on this roster prescribes for psoriasis. The trial evidence involves adding tirzepatide to a biologic already being prescribed by a dermatologist. ## Sources 1. \[1\] Lebwohl M, Blauvelt A, Kartman CE, Leatherwood C, et al. (2026). Ixekizumab With or Without Tirzepatide in Adults With Psoriasis and Overweight or Obesity: A Phase 3b Randomized Clinical Trial JAMA Dermatology. [PMID 42139049](https://pubmed.ncbi.nlm.nih.gov/42139049/) 2. \[2\] 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/) 3. \[3\] Nicolau J, et al. (2026). Semaglutide in patients with hidradenitis suppurativa and obesity Medicina Clínica. [PMID 41832804](https://pubmed.ncbi.nlm.nih.gov/41832804/) 4. \[4\] 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. 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