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FAERS Data Shows GLP-1 Drug Skin Reactions Are Less Common Than DPP-4 Inhibitor Skin Reactions

RPEP-151552026Fat, Marisa N; Johnson, Hayden C; Farberg, Aaron S
evidence
The takeaway

GLP-1 RA cutaneous adverse events (up to 8.16% of cases) were proportionally less common than DPP-4 inhibitor skin reactions (PRR 0.27), with semaglutide having the highest rate and dulaglutide the lowest.

PRR 0.27

GLP-1 drugs had proportionally 73% fewer skin adverse events compared to DPP-4 inhibitors

What the researchers found

Cutaneous AEs reported in up to 8.16% of GLP-1 RA cases; semaglutide highest rate, dulaglutide lowest. PRR 0.27 vs DPP-4 inhibitors indicates proportionally fewer skin events. Exenatide showed increased odds (OR 5.01).

Why it matters

Skin reactions can affect treatment adherence. Knowing which GLP-1 drugs have better dermatologic profiles helps guide prescribing decisions, especially as indications expand beyond diabetes.

How the study worked

Analysis of FDA FAERS data (2018-2024) for semaglutide, liraglutide, exenatide, and dulaglutide, with PRR calculation using DPP-4 inhibitors as comparator and logistic regression for predictors.

What this study cannot tell us

FAERS has inherent reporting biases. Cannot determine causation. Underreporting likely. Denominator (total prescriptions) not available for true incidence calculation.

How to read the evidence

Large pharmacovigilance database analysis. Useful for signal detection but limited by FAERS reporting biases.

When this study was published

Published in 2025 using 2018-2024 FAERS data.

The bigger picture

The overall lower skin reaction rate compared to DPP-4 inhibitors is reassuring as GLP-1 drugs expand to new indications including inflammatory skin conditions.

Questions still open

  • Why does exenatide have higher skin event odds than other GLP-1 drugs?
  • Should patients with pre-existing skin conditions prefer specific GLP-1 agents?
  • Do the immunomodulatory properties of GLP-1 drugs actually protect against some skin reactions?

Common questions

Do GLP-1 drugs cause skin problems?
Skin reactions are reported in up to 8% of cases, including rash, itching, and hives. However, GLP-1 drugs actually have proportionally fewer skin reactions than DPP-4 inhibitors (another diabetes drug class).
Which GLP-1 drug is safest for skin?
Dulaglutide had the lowest rate of skin reactions, while semaglutide had the highest. Exenatide was an outlier with significantly higher odds of skin events.

Read the original research

Cutaneous Adverse Events Associated With GLP-1 Receptor Agonists: A FAERS Database Analysis From 2018-2024.

Journal of drugs in dermatology : JDD, 25(1), 11-16

View on PubMed ↗Publisher’s paper ↗

Citation

Fat, Marisa N; Johnson, Hayden C; Farberg, Aaron S. (2026). Cutaneous Adverse Events Associated With GLP-1 Receptor Agonists: A FAERS Database Analysis From 2018-2024.. Journal of drugs in dermatology : JDD, 25(1), 11-16. https://doi.org/10.36849/JDD.9448