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. 2021 Nov;48(11):1675-1687.
doi: 10.1111/1346-8138.16084. Epub 2021 Aug 13.

Clinical characteristics and health-care resource utilization in patients with generalized pustular psoriasis using real-world evidence from the Japanese Medical Data Center database

Yukari Okubo  1 , Nirali Kotowsky  2 , Ran Gao  2 , Kumiko Saito  3 , Akimichi Morita  4
Affiliations

Clinical characteristics and health-care resource utilization in patients with generalized pustular psoriasis using real-world evidence from the Japanese Medical Data Center database

Yukari Okubo et al. J Dermatol. 2021 Nov.

Abstract

Little is known about the disease burden, health-care resource utilization (HCRU), or treatment of patients with generalized pustular psoriasis (GPP) in Japan. This retrospective cohort study used data from the Japanese Medical Data Center database to compare the demographics, comorbidities, and medication use of patients with GPP and plaque psoriasis and estimate their all-cause HCRU. The patient selection period was from January 1, 2015 to December 31, 2019, and patients must have had at least one confirmed inpatient claim or outpatient claim for GPP or plaque psoriasis. During the 12-month follow-up period, 110 patients with GPP and 20,254 patients with plaque psoriasis were identified. An age- and sex-matched (4:1) comparator control cohort, including members of the general population without a diagnosis of psoriasis (but allowing for a diagnosis of psoriatic arthritis), GPP, or palmoplantar pustulosis, was used. The most prevalent comorbidities in patients with GPP included allergic rhinoconjunctivitis, hypertension, and peptic ulcer disease. Patients with GPP were more likely to experience more comorbidities than those with plaque psoriasis, including asthma, chronic obstructive pulmonary disease, interstitial pneumonia, hyperuricemia and gout, tonsillitis, psoriatic arthritis, other psoriasis, and osteoporosis. Patients with GPP were more likely to be treated with a combination therapy than those with plaque psoriasis (65.5% vs 21.7%, respectively) and less likely to be treated with a topical medication alone (20.9% vs 50.8%). Patients with GPP had more outpatient visits than patients in the plaque psoriasis or matched control cohorts (mean [standard deviation], 14.8 [8.3] vs 11.0 [7.6] and 7.8 [7.2], respectively). They were also more likely to require inpatient hospitalization (24.5% vs 6.4% and 5.0%, respectively). Despite study limitations, patients with GPP in Japan were found to have a higher disease burden, including presence of comorbidities and medication use, than those with plaque psoriasis.

Keywords: comorbidity; disease burden; generalized pustular psoriasis; rare disease; real-world evidence.

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Conflict of interest statement

Y. Okubo declares receiving research grants from Eisai, Maruho, and Shiseido Torii, and receives current consulting/advisory board agreements and/or speakers bureau fees and/or clinical trial funds from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Eisai, Eli Lilly, Janssen Pharma, JIMRO, Kyowa Kirin, LEO Pharma, Maruho, Novartis Pharma, Pfizer, Sanofi, Sun Pharma, Taiho, Tanabe‐Mitsubishi, Torii, and UCB Pharma. A. Morita declares receiving research grants, consulting fees, and/or speaker’s fees from AbbVie, Boehringer Ingelheim, Celgene, Eli Lilly, Eisai, Janssen, Kyowa Hakko Kirin, LEO Pharma, Maruho, Mitsubishi Tanabe, Nichi‐Iko, Nippon Kayaku, Novartis, Sun Pharmaceutical Industries Taiho Pharmaceutical, Torii Pharmaceutical, and Ushio. N. Kotowsky, R. Gao, and K. Saito are employees of Boehringer Ingelheim.

Figures

FIGURE 1
FIGURE 1
Study design. †Patients were enrolled into a cohort when they fulfilled all study criteria (index date). GPP, generalized pustular psoriasis
FIGURE 2
FIGURE 2
Study population. GPP, generalized pustular psoriasis; ICD‐10, International Classification of Diseases 10th revision; PPP, palmoplantar pustulosis
FIGURE 3
FIGURE 3
Proportions of patients with the most common comorbidities during the 12‐month follow‐up period. COPD, chronic obstructive pulmonary disease; GPP, generalized pustular psoriasis
FIGURE 4
FIGURE 4
Medication use in patients with GPP and plaque psoriasis during the 12‐month follow‐up period. GPP, generalized pustular psoriasis; TNF, tumor necrosis factor
FIGURE 5
FIGURE 5
Most common concomitant medication use during the 12‐month follow‐up period. COPD, chronic obstructive pulmonary disease; GPP; generalized pustular psoriasis
See this image and copyright information in PMC

References

    1. Augey F, Renaudier P, Nicolas JF. Generalized pustular psoriasis (Zumbusch): a French epidemiological survey. Eur J Dermatol. 2006;16:669–73. - PubMed
    1. Boehner A, Navarini AA, Eyerich K. Generalized pustular psoriasis ‐ a model disease for specific targeted immunotherapy, systematic review. Exp Dermatol. 2018;27:1067–77. - PubMed
    1. Fujita H, Terui T, Hayama K, Akiyama M, Ikeda S, Mabuchi T, et al. Japanese guidelines for the management and treatment of generalized pustular psoriasis: the new pathogenesis and treatment of GPP. J Dermatol. 2018;45:1235–70. - PubMed
    1. Navarini AA, Burden AD, Capon F, Mrowietz U, Puig L, Köks S, et al. European consensus statement on phenotypes of pustular psoriasis. J Eur Acad Dermatol Venereol. 2017;31:1792–9. - PubMed
    1. Kharawala S, Golembesky AK, Bohn RL, Esser D. The clinical, humanistic, and economic burden of generalized pustular psoriasis: a structured review. Expert Rev Clin Immunol. 2020;16:239–52. - PubMed

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