# Mortality on GLP-1 Drugs in Hidradenitis Suppurativa: A Record Study | This GLP A TriNetX cohort reported all-cause mortality at HR 0.24 in GLP-1 users with hidradenitis suppurativa. The size of the effect is the reason to doubt it. Publisher: This GLP Editorial Team Canonical: https://thisglp.com/research/glp1-mortality-in-hidradenitis Updated: 2026-09-18 Published: 2026-09-16 [← Research](https://thisglp.com/research) Evidence # Mortality on GLP-1 Drugs in Hidradenitis Suppurativa: A Record Study A matched-record study found three quarters of deaths missing in GLP-1 users over two years. Randomized trials move mortality by about a fifth. [This GLP Editorial Team](https://thisglp.com/about)September 20267 min readUpdated September 2026 One matched cohort, eight outcomes, two years · no difference · all-cause death · 0.24 · suicidal ideation · 0.38 · substance use disorder · 0.58 · major cardiac events · 0.61 · depression · 0.78 · hyperlipidemia · 1.25 · nausea and vomiting · 1.31 · fatty liver disease · 1.37 **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). ## Key takeaways - A matched-record cohort of adults with hidradenitis suppurativa plus diabetes or obesity, two years of follow-up. - All-cause mortality: hazard ratio 0.24, 95% CI 0.145 to 0.395. - That is three quarters of deaths not happening. Randomized trials of these drugs move mortality by about a fifth. - Exposure required at least a year of therapy. Nobody who died in that year could be exposed. - The same table reports hyperlipidemia at 1.25, fatty liver disease at 1.37 and nausea at 1.31. Some results are too good to believe. This is one. The finding is not wrong because it is large. It is doubtful because of how large it is, and where it came from. ## What the study did Adults with hidradenitis suppurativa and either type 2 diabetes or obesity were pulled from a US record network. [\[1\]](https://thisglp.com/research/glp1-mortality-in-hidradenitis#ref-1) Those on a GLP-1 drug or tirzepatide were matched one-to-one against those on other metabolic medicines. Outcomes were followed two years. The skin disease defines who is in the study. It is not an outcome. Nothing here measured whether anyone’s hidradenitis got better. ## The number that stops you All-cause mortality came out at 0.24, interval 0.145 to 0.395. Three quarters of deaths, gone. Compare that to a randomized trial. SELECT moved all-cause death by roughly a fifth over four years, and that is the largest properly randomized read we have — the same body of evidence that a [Cochrane review of eighteen trials](https://thisglp.com/research/semaglutide-cochrane-review) graded. A four-fold larger effect, in two years, in unrandomized records, is not a discovery. It is what we should expect when the people who get a drug differ from the people who do not. Who can be counted as exposed Exposure here required at least one year of therapy. Somebody who died in month three never completes that year, so they cannot join the treated group. They can only appear among the controls. That alone can manufacture a mortality benefit out of nothing. Whether it did depends on when the follow-up clock starts, and the abstract does not say. It is the first question to ask of the full paper, and it is not a small one. ## The rest of the table Major cardiac events came out at 0.61. Stroke and heart failure both fell. Depression came out at 0.78, substance use disorder at 0.58, suicidal ideation at 0.38. These cannot be separated from the mortality figure. They are the same people, matched the same way, over the same two years. If the design can produce 0.24 for death, it can produce 0.38 for suicidal ideation, and nobody gets to keep the reassuring rows and discard the implausible one — the problem [every large matched-record study](https://thisglp.com/research/do-glp1-drugs-cause-kidney-cancer) carries. Three things went up: hyperlipidemia at 1.25, fatty liver disease at 1.37, nausea and vomiting at 1.31. Those come with the same caveat and deserve the same weight. ## Why healthy people get prescriptions Doctors do not start an expensive injectable in somebody who is dying. They start it in people well enough to benefit, who show up, and who can pay. Everyone in the comparison group was on some other metabolic drug, which helps. It does not fix it. Matching handles what got recorded, and how sick somebody looks in clinic is mostly not recorded — the same gap behind [who ends up meeting an indication](https://thisglp.com/research/who-qualifies-for-semaglutide-for-liver-disease). ## What to do with it Read it as a hypothesis about a population nobody studies much. That is a real contribution. Do not read 0.24 as a mortality benefit. A ratio needs its absolute counts before it means anything, and [the counts are usually smaller than the ratio sounds](https://thisglp.com/research/glp1-liver-cancer-absolute-risk). An effect this size showing up only outside a trial is the oldest warning sign in observational medicine, and [the reverse error](https://thisglp.com/research/does-a-glp1-affect-surgery-outcomes) is just as common. ## Frequently asked Do GLP-1 drugs cut the risk of death by three quarters? No trial has shown anything like that. This is an unrandomized record study, and an effect four times larger than the randomized evidence is a reason to doubt the design rather than to believe the drug. What is wrong with requiring a year of treatment? Anybody who dies before completing it cannot be counted as exposed, so early deaths fall to the control group. That can create a survival benefit on its own, depending on when follow-up starts. Did anything get worse in this study? Yes. Hyperlipidemia came out at 1.25, fatty liver disease at 1.37 and nausea with vomiting at 1.31, in the same matched data. Did the study measure hidradenitis suppurativa itself? No. The skin disease defines who was included. No outcome in the analysis describes whether it improved. ## Sources 1. \[1\] 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/) ## 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. 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