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与 GLP-1 激动剂相关的罕见皮肤不良反应:文献复习。

Rare cutaneous adverse reactions associated with GLP-1 agonists: a review of the published literature.

机构信息

Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA.

Harvard Medical School, Boston, MA, USA.

出版信息

Arch Dermatol Res. 2024 May 25;316(6):248. doi: 10.1007/s00403-024-02969-3.

Abstract

Glucagon-like-peptide-1 (GLP-1) agonists are an emerging class of medications used to manage type 2 diabetes mellitus (T2DM) and weight loss, with demonstrated efficacy in reducing hemoglobin A1c levels, body mass index, and adverse cardiovascular events. While previous studies have reviewed notable cutaneous adverse effects with other antidiabetic medications, little is known about GLP-1 agonist-induced cutaneous reactions. Nevertheless, rare but significant cutaneous adverse reactions have been reported, including but not limited to dermal hypersensitivity reactions, eosinophilic panniculitis, bullous pemphigoid, and morbilliform drug eruptions. As GLP-1 induced cutaneous reactions are diverse, diagnosis requires clinical suspicion, thorough history-taking, and supportive histopathological findings when available. Management involves cessation of the offending agent with a tailored regimen to address inflammatory and/or immunogenic etiologies as well as irritative symptoms. This review aims to consolidate available information from case reports and case series regarding rare skin-related adverse outcomes due to GLP-1 use, aiming to provide a comprehensive overview of the presentation, pathogenesis, and management for dermatologists and other clinicians.

摘要

胰高血糖素样肽-1(GLP-1)激动剂是一类新兴的药物,用于治疗 2 型糖尿病(T2DM)和减肥,已被证明能有效降低血红蛋白 A1c 水平、体重指数和不良心血管事件。虽然之前的研究已经综述了其他抗糖尿病药物的显著皮肤不良反应,但对 GLP-1 激动剂引起的皮肤反应知之甚少。然而,已经报道了罕见但严重的皮肤不良反应,包括但不限于皮肤过敏反应、嗜酸性粒细胞性脂膜炎、大疱性类天疱疮和麻疹样药物疹。由于 GLP-1 诱导的皮肤反应多种多样,诊断需要临床怀疑、详细的病史采集以及有支持性的组织病理学发现。治疗包括停用致病药物,并根据炎症和/或免疫原性病因以及刺激性症状制定个体化方案。本综述旨在从病例报告和病例系列中整合关于 GLP-1 应用引起的罕见皮肤相关不良结局的现有信息,旨在为皮肤科医生和其他临床医生提供有关其表现、发病机制和管理的全面概述。

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