GLP-1RAs Linked with Reduced Itch Prevalence in Diabetes Cohort
Key Takeaways
Chronic pruritus is common in type 2 diabetes mellitus (T2DM) and may be reduced with GLP-1 receptor agonist therapy.
Semaglutide, dulaglutide, and tirzepatide were associated with greater itch reduction than metformin.
Anti-inflammatory effects may underlie the observed benefit, researchers said.
Results from a new retrospective cohort analysis suggest some glucagon-like peptide-1 (GLP-1) receptor agonists are associated with a reduced prevalence of itch the type 2 diabetes mellitus (T2DM), independent of glycemic control.
"Glucagon-like peptide-1 (GLP-1) agonists have reportedly decreased itch in diabetics with concurrent psoriasis; however, their role in targeting itch specifically remains unknown," the authors wrote. "To investigate the association of GLP-1 agonists and pruritus prevalence in T2DM, we conducted a retrospective cohort study utilizing the TriNetX database."
The GLP-1RAs included semaglutide, dulaglutide, liraglutide, or tirzepatide. The authors compared outcomes with diabetic patients not receiving GLP-1RAs plus those prescribed metformin. Cohorts were propensity matched for demographics, comorbidities, and concomitant medications, with infectious causes of itch and injection-site reactions excluded. Pruritus prevalence was assessed at 14 days, 3 months, 6 months, and 12 months after treatment initiation.
All GLP-1 agents were associated with lower pruritus rates compared withg untreated controls as early as 2 weeks. Over the course of 1 year, semaglutide, dulaglutide, and tirzepatide demonstrated further reductions in itch prevalence. Liraglutide did not significantly reduce pruritus at any time point vs. metformin, but semaglutide, dulaglutide, and tirzepatide showed early benefit, with sustained improvement at 1 year for semaglutide and tirzepatide.
"Diabetics without neuropathy were associated with greater or similar itch improvement after GLP-1 therapy compared to diabetics with neuropathy," they wrote. "As such, it is unlikely that GLP-1s decrease itch through neuropathy relief. Instead, although the exact mechanism is currently unclear, it is possible that GLP-1 agonists’ anti-inflammatory effects dampen itch."
Study limitations included reliance on ICD coding, lack of dosage/adherence data, and the observational study design.
Source: Chu D, et al. Journal of Drugs in Dermatology. January 2026;25(1):e24.