Abstract
A 59-year old man with moderate and stable psoriasis through 15 years was admitted to our Department with inadequately controlled type 2 diabetes. Treatment was initiated with the glucagon-like peptide-1 receptor (GLP-1R) agonist liraglutide. The patient experienced marked improvement in his psoriasis immediately after the start of liraglutide treatment. Itching stopped within days, scaling was reduced and spots of normal skin emerged. After 3 months, psoriasis was still improving. Excellent glycaemic control and a weight loss of approximately 8 kg over 3 months were moreover obtained. The patient had previously been well controlled in his diabetes without improvement in psoriasis, and the effect of liraglutide on psoriasis started before weight loss occurred. We discuss the possibility of a direct anti-inflammatory effect of liraglutide in psoriasis as well as indirect effects through improvement in comorbidities such as overweight. Randomized clinical trials are needed to reveal whether GLP-1R agonists represent a new therapeutic option for psoriasis.
References
Holst JJ (2007) The physiology of glucagon-like peptide 1. Physiol Rev 87:1409–1439
Hare KJ, Knop FK (2010) Incretin-based therapy and type 2 diabetes. Vitam Horm 84:389–413
Astrup A, Rössner S, Van Gaal L, Rissanen A, Niskanen L, Al Hakim M, Madsen J, Rasmussen MF, Lean ME, NN8022-1807 Study Group (2009) Effects of liraglutide in the treatment of obesity: a randomised, double-blind, placebo-controlled study. Lancet 374(9701):1606–1616
Setty AR, Curhan G, Choi HK (2007) Obesity, waist circumference, weight change, and the risk of psoriasis in women: Nurses’ Health Study II. Arch Intern Med 167:1670–1675
Gelfand JM, Neimann AL, Shin DB, Wang X, Margolis DJ, Troxel AB (2006) Risk of myocardial infarction in patients with psoriasis. JAMA 296(14):1735–1741
Ahlehoff O, Gislason GH, Charlot M, Jørgensen CH, Lindhardsen J, Olesen JB, Abildstrøm SZ, Skov L, Torp-Pedersen C, Hansen PR (2011) Psoriasis is associated with clinically significant cardiovascular risk: a Danish nationwide cohort study. J Intern Med 270(2):147–157
Qureshi AA, Choi HK, Setty AR, Curhan GC (2009) Psoriasis and the risk of diabetes and hypertension: a prospective study of US female nurses. Arch Dermatol 145(4):379–382
Kodera R, Shikata K, Kataoka HU, Takatsuka T, Miyamoto S, Sasaki M, Kajitani N, Nishishita S, Sarai K, Hirota D, Sato C, Ogawa D, Makino H (2011) Glucagon-like peptide-1 receptor agonist ameliorates renal injury through its anti-inflammatory action without lowering blood glucose level in a rat model of type 1 diabetes. Diabetologia 54(4):965–978
Hadjiyanni I, Siminovitch KA, Danska JS, Drucker DJ (2010) Glucagon-like peptide-1 receptor signalling selectively regulates murine lymphocyte proliferation and maintenance of peripheral regulatory T cells. Diabetologia 53(4):730–740
Marx N, Burgmaier M, Heinz P, Ostertag M, Hausauer A, Bach H, Durst R, Hombach V, Walcher D (2010) Glucagon-like peptide-1(1–37) inhibits chemokine-induced migration of human CD4-positive lymphocytes. Cell Mol Life Sci 67(20):3549–3555
Kim Chung le T, Hosaka T, Yoshida M, Harada N, Sakaue H, Sakai T, Nakaya Y (2009) Exendin-4, a GLP-1 receptor agonist, directly induces adiponectin expression through protein kinase A pathway and prevents inflammatory adipokine expression. Biochem Biophys Res Commun 390(3):613–618
Dozier KC, Cureton EL, Kwan RO, Curran B, Sadjadi J, Victorino GP (2009) Glucagon-like peptide-1 protects mesenteric endothelium from injury during inflammation. Peptides 30(9):1735–1741
Hattori Y, Jojima T, Tomizawa A, Satoh H, Hattori S, Kasai K, Hayashi T (2010) A glucagon-like peptide-1 (GLP-1) analogue, liraglutide, upregulates nitric oxide production and exerts anti-inflammatory action in endothelial cells. Diabetologia 53(10):2256–2263
Hogan AE, Tobin AM, Ahern T, Corrigan MA, Gaoatswe G, Jackson R, O’Reilly V, Lynch L, Doherty DG, Moynagh PN, Kirby B, O’Connell J, O’Shea D (2011) Glucagon-like peptide-1 (GLP-1) and the regulation of human invariant natural killer T cells: lessons from obesity, diabetes and psoriasis. Diabetologia 54(11):2745–2754
Nishioka T, Tanimoto N, Kumagai C, Hashimoto K (2011) Sitagliptin, a dipeptidyl peptidase-IV inhibitor, improves psoriasis. Dermatology [Epub ahead of print]
List JF, He H, Habener JF (2006) Glucagon-like peptide-1 receptor and proglucagon expression in mouse skin. Regul Pept 134(2–3):149–157
Higa-Sansone G, Szomstein S, Soto F, Brasecsco O, Cohen C, Rosenthal RJ (2004) Psoriasis remission after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Obes Surg 14(8):1132–1134
De Menezes Ettinger JE, Azaro E, de Souza CA, dos Santos Filho PV, Mello CA, Neves M Jr, de Amaral PC, Fahel E (2006) Remission of psoriasis after open gastric bypass. Obes Surg 16(1):94–97
Hossler EW, Maroon MS, Mowad CM (2011) Gastric bypass surgery improves psoriasis. J Am Acad Dermatol 65(1):198–200
Laferrére B (2009) Effect of gastric bypass surgery on the incretins. Diabetes Metab 35(6 Pt 2):513–517
Noyan-Ashraf MH, Momen MA, Ban K, Sadi AM, Zhou YQ, Riazi AM, Baggio LL, Henkelman RM, Husain M, Drucker DJ (2009) GLP-1R agonist liraglutide activates cytoprotective pathways and improves outcomes after experimental myocardial infarction in mice. Diabetes 58:975–983
Nyström T, Gutniak MK, Zhang Q, Zhang F, Holst JJ, Ahrén B, Sjöholm A (2004) Effects of glucagon-like peptide-1 on endothelial function in type 2 diabetes patients with stable coronary artery disease. Am J Physiol Endocrinol Metab 287:E1209–E1215
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Faurschou, A., Knop, F.K., Thyssen, J.P. et al. Improvement in psoriasis after treatment with the glucagon-like peptide-1 receptor agonist liraglutide. Acta Diabetol 51, 147–150 (2014). https://doi.org/10.1007/s00592-011-0359-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00592-011-0359-9