A Retrospective Comparative Analysis of Cutaneous Adverse Reactions in GLP-1 Agonist Therapies

April 2025 | Volume 24 | Issue 4 | 413 | Copyright © April 2025


Published online March 7, 2025

doi:10.36849/JDD.8605

Sophia Daniel BSa,b, Stephanie Waggett BSa,c, Elliott Lyles BSa, Pelin Sagut MDa,d, Parisa Shamaei Zadeh MSPHb, Anthony Marcelletti BHSb, Carol Stegura MEc, Lara Wine Lee MD PhDd

aCollege of Graduate Studies, Medical University of South Carolina, Charleston, SC
bCollege of Medicine, University of Kentucky, Lexington, KY
cCollege of Medicine, Medical University of South Carolina, Charleston, SC
dDepartment of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, SC

Abstract
Glucagon-like peptide-1 (GLP-1) agonists are used to treat type 2 diabetes mellitus (T2DM) and have recently gained approval and popularity for treating obesity and weight loss. There is a lack of data evaluating the types of reactions associated with this medication class, and this study aimed to characterize the types of cutaneous reactions seen across different GLP-1 agonists, and whether differences exist in reactions based on the reason for medication use. Through a retrospective review of cutaneous adverse events associated with semaglutide, dulaglutide, tirzepatide, lixisenatide, liraglutide, and exenatide in the FDA Adverse Event Reporting System, it was found that the 5 most common cutaneous reactions associated with GLP-1 agonists were eczematous, pruritus, drug eruptions, hyperhidrosis, and alopecia. Life-threatening cutaneous adverse events accounted for 2.17% of all cutaneous reactions, with no statistically significant differences observed between drug types. It was also found that GLP-1 agonist use for T2DM exhibited significantly higher rates of alopecia (P=0.000) and hyperhidrosis (P=0.000) in comparison to use for weight management.

J Drugs Dermatol. 2025;24(4):413-415. doi:10.36849/JDD.8605

INTRODUCTION

Glucagon-like peptide-1 (GLP-1) agonists are used to treat type 2 diabetes mellitus (T2DM) and have recently gained approval and popularity for treating obesity and weight loss. With the recent increase in prescriptions,1 a notable gap in the literature still exists regarding comprehensive evaluations and comparisons of cutaneous reactions in this medication class. This study aimed to characterize the types of cutaneous reactions seen across different GLP-1 agonists and to determine whether differences exist in reactions based on the reason for medication use.

Cutaneous adverse events (CAEs) to GLP-1 agonists were retrospectively reviewed using the FDA Adverse Event Reporting System (FAERS).2 Medications reviewed included: semaglutide, dulaglutide, tirzepatide, lixisenatide, liraglutide, and exenatide. Adverse events (AEs) reviewed were limited to those categorized as "Skin and Subcutaneous Tissue Disorders" reactions with a single suspected offending drug from the previously listed medications. Reactions were grouped into categories such as life-threatening, drug eruptions, eczematous reactions, etc, (Table 1). CAEs were then filtered and grouped into the reason for use in the following groups: T2DM, weight management (WM), and T2DM+WM. Chi-Square (or Fisher's