Cutaneous Adverse Events Associated With GLP-1 Receptor Agonists: A FAERS Database Analysis From 2018-2024

January 2026 | Volume 25 | Issue 1 | 11 | Copyright © January 2026


Published online December 31, 2025

Marisa N. Fat BSa, Hayden C. Johnson BA MQEb, Aaron S. Farberg MDc,d,e

aAnne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, TX
bDepartment of Graduate Education, University of California, Los Angeles, Los Angeles, CA
cBare Dermatology, Dallas, TX
dDepartment of Dermatology, Baylor Scott & White Health System, Dallas, TX
eUniversity of North Texas Health Science Center, Fort Worth, TX

Abstract
Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for conditions beyond type 2 diabetes, including psoriasis and hidradenitis suppurativa. Despite this, little is known about their dermatologic safety profiles.
Methods: We analyzed FDA Adverse Event Reporting System (FAERS) data from 2018 to 2024 for semaglutide, liraglutide, exenatide, and dulaglutide. Cutaneous adverse events (AEs) were identified using MedDRA-coded terms: "rash," "pruritus," "urticaria," "alopecia," and "angioedema". Frequency and proportional reporting ratios (PRRs) were calculated using dipeptidyl peptidase-4 (DPP-4) inhibitors as a comparator. Logistic regression assessed predictors of cutaneous AEs, with dulaglutide as a reference and sex, age, and GLP-1 RA type as independent variables.
Results: Cutaneous AEs were reported in up to 8.16% of GLP-1 RA cases, more often in females, with a mean patient age of 60. Semaglutide was associated with the highest rate, and dulaglutide the lowest. PRR analysis (0.27; 95% CI: 0.257-0.284) showed these AEs were proportionally less common relative to DPP-4 inhibitor users. Exenatide was associated with increased odds (OR = 5.01, 95% CI: 4.69–5.35), while liraglutide and semaglutide showed decreased odds.
Discussion: Possibly influenced by dosage, immune modulation, and patient perception of efficacy, cutaneous GLP-1RA adverse effects were less frequent than DPP-4 inhibitors, but still warrant clinician awareness. These reactions might impact patient adherence, which highlights the need for further investigation into their mechanisms.
Conclusion: Cutaneous AEs are infrequent but vary by GLP-1 RA. Greater awareness may improve patient counseling as indications expand.

 

INTRODUCTION

Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) are a class of medications that have been widely used for the control of Type 2 Diabetes Mellitus (T2DM).1 A GLP-1 RA stimulates insulin release from the pancreas after glucose is introduced into the body through food or drink. GLP-1 RAs help augment this effect and promote delayed gastric emptying and inhibition of glucagon production in order to prevent blood sugar levels from rising.1 These medications are now being prescribed by dermatologists for conditions such as hidradenitis suppurativa and psoriasis, not just those experiencing T2DM.2 With the rapid rise of off-label use of GLP-1 RAs, understanding the safety profile of these medications has become imperative.

Multiple adverse events from GLP-1 RAs have been documented, most notably nausea, vomiting, and diarrhea;3 however, little is known about skin-related side effects. Some studies have mentioned potential safety concerns for cutaneous adverse events such as alopecia, but these types of reactions remain underreported in pharmacological literature and have yet to be studied independently.4

Monitoring cutaneous AEs from GLP-1 RAs is important, particularly in the fields of dermatology and primary care. This study uses the FDA Adverse Event Reporting System (FAERS), an information database that contains reports of adverse events from medications that were submitted to the FDA.5 The aim of

Keywords: GLP-1RA, safety, FAERS, rash, semaglutide, exenatide
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