Patients taking semaglutide may have higher rate of “altered skin sensations” and alopecia, finds review

“Variations in administration routes and dosage could impact the types and severity of skin findings, highlighting the need for additional research,” Megan M. Tran, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA, and colleagues wrote in their study.

The MedWatch program of the US Food and Drug Administration (FDA) has not received reports of semaglutide-related safety events, and few studies have characterized skin findings associated with subcutaneous or oral semaglutide, a glucagon-like peptide 1 agonist used for obesity and type 2 diabetes treatment.

The scoping review included 22 articles (15 clinical trials, six case reports, and one retrospective cohort study), published through January 2024, of patients receiving either semaglutide or a placebo or comparator, including reports of semaglutide-associated adverse dermatologic events in 255 participants.

Based on the review, the researchers reported the following findings:

• Patients who received weekly 50 mg oral semaglutide reported a higher incidence of altered skin sensations, such as dysesthesia (1.8% versus 0%), hyperesthesia (1.2% versus 0%), skin pain (2.4% versus 0%), paresthesia (2.7% versus 0%), and sensitive skin (2.7% versus 0%), than those receiving placebo or comparator.
• Reports of alopecia (6.9% versus 0.3%) were higher in patients who received 50 mg oral semaglutide weekly than in those on placebo, however, only 0.2% of patients on 2.4 mg of subcutaneous semaglutide reported alopecia versus 0.5% of those on placebo.
• Unspecified dermatologic reactions (4.1% vs 1.5%) were reported in more patients on subcutaneous semaglutide than those on a placebo or comparator.
• Several case reports described isolated cases of severe skin-related adverse effects, such as bullous pemphigoid, eosinophilic fasciitis, and leukocytoclastic vasculitis.
• Injection site reactions (3.5% vs 6.7%) were less common in patients on subcutaneous semaglutide than those on a placebo or comparator.

The limitation of the study is that it could not adjust for confounding factors and could not establish a direct causal association between semaglutide and the adverse reactions reported.

In conclusion, the review of 22 articles revealed that patients taking oral semaglutide had a higher rate of alopecia and “altered skin sensations” when compared with those getting a placebo.

Variations in dosage and administration routes could influence the severity and types of skin findings, underscoring the need for additional research.

Reference:

Tran, M. M., Mirza, F. N., Lee, A. C., Goldbach, H., Libby, T. J., & Wisco, O. J. (2024). Dermatologic findings associated with semaglutide use: A scoping review. Journal of the American Academy of Dermatology. https://doi.org/10.1016/j.jaad.2024.03.021