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胰高血糖素样肽-1受体激动剂的获益-风险评估:对皮肤科医生和整形外科医生的启示

Benefit-Risk Assessment of GLP-1 Receptor Agonists: Implications for Dermatologists and Plastic Surgeons.

作者信息

Cedirian Stephano, Donati Monia, Rapparini Luca, Pampaloni Francesca, La Placa Michelangelo, Sgarzani Rossella, Negosanti Luca, Raschi Emanuel, Starace Michela

机构信息

Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Bologna, Italy.

Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.

出版信息

Dermatol Ther (Heidelb). 2025 Sep 9. doi: 10.1007/s13555-025-01537-5.

Abstract

Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have gained prominence for their efficacy in treating type 2 diabetes and obesity. Recent evidence suggests that their pleiotropic effects-beyond glycemic control and weight loss-include anti-inflammatory, immunomodulatory, and antioxidative effects, which may beneficially support various dermatologic conditions such as psoriasis, hidradenitis suppurativa, acanthosis nigricans, and Hailey-Hailey disease. However, GLP-1 RAs are also associated with emerging cutaneous adverse drug reactions, including bullous, exanthematous and vasculitic manifestations, and other rare side effects. In aesthetic and reconstructive surgery, rapid weight loss induced by these agents has raised concerns regarding facial volume depletion, skin laxity, and impaired wound healing. In addition, perioperative management of patients on GLP-1 RAs requires careful assessment as a result of delayed gastric emptying and the associated potential risk of pulmonary aspiration. This narrative review summarizes current knowledge on the benefit/risk profile of GLP-1 RAs, highlighting their impact for dermatologists and plastic surgeons in relevant contexts.

摘要

胰高血糖素样肽1受体激动剂(GLP-1 RAs)因其在治疗2型糖尿病和肥胖症方面的疗效而备受关注。最近的证据表明,它们的多效性作用——超出血糖控制和体重减轻——包括抗炎、免疫调节和抗氧化作用,这可能对各种皮肤病有益,如银屑病、化脓性汗腺炎、黑棘皮病和黑利-黑利病。然而,GLP-1 RAs也与新出现的皮肤药物不良反应有关,包括大疱性、疹性和血管炎表现以及其他罕见副作用。在美容和重建手术中,这些药物引起的快速体重减轻引发了对面部容积减少、皮肤松弛和伤口愈合受损的担忧。此外,由于胃排空延迟以及相关的肺误吸潜在风险,对接受GLP-1 RAs治疗的患者进行围手术期管理需要仔细评估。这篇叙述性综述总结了关于GLP-1 RAs益处/风险概况的当前知识,强调了它们在相关背景下对皮肤科医生和整形外科医生的影响。

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