Discussing Promising New Findings on GLP-1 Use in Psoriasis Management, With Neal Bhatia, MD

Adults with moderate-to-severe plaque psoriasis and obesity or overweight saw significant improvements in both conditions after using combined ixekizumab (Taltz) and tirzepatide (Zepbound) when compared to those using ixekizumab alone, according to recent data.1,2

Following the release of these data by Eli Lilly and Company, resulting from the phase 3b TOGETHER-PsO trial (NCT06588283), the HCPLive editorial team interviewed Neal Bhatia, MD, the director of Clinical Dermatology at Therapeutics Clinical Research, to discuss these new data and their significance for weight loss and psoriasis.

“Mechanistically, it makes a lot of sense when you see what GLP-1 agonists do under the hood, with the immune mechanisms,” Bhatia said. “There's a lot of impact on [nuclear factor kappa B] as a neurotransmitter. Both interleukin 1 and interleukin 17 pathways are actually inhibited, or at least modulated, by their impact. Tumor necrosis factor…is suppressed just by trazepatide alone. Then you add just the active ingredient of what ixekizumab does as an IL-17 inhibitor.”

Bhatia touched on both the impacts of these 2 drugs in the open-label TOGETHER-PsO trial, highlighting their combined effects on skin clearance and weight loss in patients with psoriasis and elevated body mass index (BMI). He explained the synergistic impact of GLP-1 agonists on immune pathways, including NF-κB, interleukin (IL)-1, and tumor necrosis factor.

The investigators for TOGETHER-PsO had highlighted 27.1% of patients on the combination therapy achieved both PASI 100 and a minimum of 10% reduction in their weight, as opposed to only 5.8% of individuals treated with ixekizumab alone (P < .001).1,2 Additionally, they had highlighted 40.6% of those in the combination arm achieved PASI 100 versus 29.0% in the monotherapy arm (P < .05).

“[There are] a lot of opportunities to improve these patients along,” Bhatia explained. “Now, these are at 36 weeks, so this is a marathon, not a sprint, even though these drugs all work very fast.”

Bhatia noted future research on tirzepatide alone and its potential benefits in other diseases like hidradenitis suppurativa could be worth exploring. He also stressed the value of dermatologists and other clinicians integrating metabolic management into their practice to improve patient outcomes.

The quotes used in this summary were edited for the purposes of clarity.

Bhatia has reported serving as an advisor, consultant, and investigator for AbbVie, Almirall, Arcutis Biotherapeutics, Beiersdorf, Biofrontera, Boehringer Ingelheim, Bristol Myers Squibb, Cara Therapeutics, Dermavant Sciences, EPI Health, Ferndale, Galderma, Incyte, ISDIN, Johnson & Johnson, La Roche-Posay, LEO Pharma, Lilly, Ortho Dermatologics, Pfizer, Regeneron Pharmaceuticals, Sanofi, Sun Pharma, and Verrica Pharmaceuticals.

References

1. Lilly's Taltz (ixekizumab) and Zepbound (tirzepatide) used together delivered superior efficacy in first-of-its-kind Phase 3b trial for adults with psoriasis and obesity or overweight. Eli Lilly. February 18, 2026. Accessed February 26, 2026. https://investor.lilly.com/news-releases/news-release-details/lillys-taltz-ixekizumab-and-zepbound-tirzepatide-used-together-0.

2. Smith T. Ixekizumab, Tirzepatide Effective Together for Psoriasis and Obesity or Overweight. HCPLive. February 18, 2026. Accessed February 26, 2026. https://www.hcplive.com/view/ixekizumab-tirzepatide-effective-together-psoriasis-obesity-overweight.