Effects of Semaglutide on Clinical Outcomes and Metabolic Inflammation in Psoriasis

Inclusion criteria

• Male or female participants aged ≥18 years at the time of randomization.
• Clinical diagnosis of plaque psoriasis with Psoriasis Area and Severity Index (PASI) ≥3 and body surface area (BSA) ≥3%.
• Body mass index (BMI) ≥25 kg/m², consistent with overweight or obesity.
• Participants with or without type 2 diabetes mellitus.
• Participants with diabetes must be on stable antidiabetic therapy (no changes in medication or dosage within the previous 3 months) and have adequate glycemic control, defined as HbA1c ≤9.0% at baseline.
• No use of systemic psoriasis therapies (e.g., methotrexate, cyclosporine) for at least 8 weeks prior to randomization.
• No use of biologic therapies for at least 3 months prior to randomization.

Exclusion criteria

• Diagnosis of a non-plaque psoriasis subtype, including pustular, guttate, nail, inverse, psoriatic arthritis, or erythrodermic psoriasis.
• Pregnancy or breastfeeding at the time of screening or enrollment.
• Insulin-dependent diabetes mellitus or current use of sulfonylureas.
• Active malignancy at the time of screening.
• History of thyroid neoplasia.
• Presence of autoimmune diseases.
• Use of systemic therapies within 8 weeks prior to randomization.
• Use of biologic therapies within 3 months prior to randomization.
• Renal insufficiency.
• Heart failure.
• Hepatic insufficiency.
• History of pancreatitis.
• Current treatment with other GLP-1 receptor agonists.
• History of inflammatory bowel disease.
• Known allergy to starch.