Biologics are important treatment options for psoriasis; however, direct comparison of their efficacy, safety, and drug survival is insufficient in clinical practice. This retrospective single-center study aimed to compare the efficacy, safety, and drug survival of three commonly used psoriasis biologics (secukinumab, ustekinumab, and guselkumab) and identify the factors affecting drug survival in actual clinics in Korea. We enrolled 111 patients with moderate to severe psoriasis and for at least 56 weeks of follow-up; among these, 27, 23, and 61 were administered secukinumab, ustekinumab, and guselkumab, respectively. All groups were comparable with respect to their baseline characteristics. Secukinumab showed a rapid response, and guselkumab was superior in terms of a long-term response and complete remission compared with other biologics, while ustekinumab showed a lower efficacy compared with other biologics. All three biologics had a favorable and similar safety profile; however, allergic reactions and latent tuberculosis were more common with secukinumab and ustekinumab, respectively. Guselkumab was the most sustained biologic, and the survival rates of secukinumab and ustekinumab were similar. Drug survival was remarkably shorter in female patients and those with hypertension. Introduction of new biologics emerged as a negative factor for drug survival in clinical settings.
Hidradenitis suppurativa (HS) is associated with various metabolic and autoimmune diseases. The epidemiology has been analyzed in various studies worldwide. However, epidemiological data on HS for Asian populations are limited. This study aimed to analyze the change in the prevalence and incidence of HS over 17 years in South Korea using the Korean National Health Insurance Service (NHIS) database. This study also evaluated the comorbidities in patients with HS. Population‐based data from the NHIS database of Korea were obtained between January 2003 and December 2019. Odds ratios were estimated to determine the association between comorbidities and HS during the study period. Hazard ratios for the risk of incident comorbidities in patients with HS were obtained using the multivariable Cox proportional hazard analysis. This study included 45 511 patients with HS and 910 220 controls matched for age, sex, insurance type, and income level. The incidence rate of HS per 1 000 000 person‐years in Korea increased from 11.69 in 2003 to 78.78 in 2019. The annual prevalence per 1 000 000 people also increased from 34.68 in 2003 to 140.10 in 2019, showing a similar trend. Many comorbidities, including atopic, metabolic and end‐organ, autoimmune/inflammatory, and psychiatric diseases were associated with HS at baseline. In many diseases, the risk of incident comorbidities in patients with HS was higher than that in controls. The incidence and prevalence of HS in Korea have increased over the past 17 years. Various comorbidities, including allergic diseases, hypertension, diabetes mellitus, dyslipidemia, myocardial infarction, chronic hepatitis and cirrhosis, chronic kidney disease, inflammatory bowel diseases, rheumatoid arthritis, vitamin D deficiency, and psychiatric diseases, were associated with HS. Physicians need to keep in mind and closely monitor these comorbidities in patients with HS.
Background Various comorbid diseases have been reported in patients with lichen planopilaris (LPP); however, data regarding the risks of incident diseases and mortality are lacking. Methods This was a retrospective nationwide population-based study, using data from the National Health Insurance Service Database of Korea from 2002 to 2019. Patients aged ≥18 years with ≥3 documented medical visits for LPP were included. The adjusted hazard ratios (aHRs) for incident disease outcomes and mortality were compared with 1:20 age-, sex-, insurance type-, and income level-matched controls. Results In total, 2,026 patients with LPP and 40,520 controls were analysed. The risks of incident systemic lupus erythematosus (aHR, 1.91; 95% confidence interval [CI], 1.21–3.03), psoriasis (aHR, 3.42; 95% CI, 2.83–4.14), rheumatoid arthritis (aHR, 1.39; 95% CI, 1.19–1.63), lichen planus (aHR, 10.07; 95% CI, 7.17–14.15), atopic dermatitis (aHR, 2.15; 95% CI, 1.90–2.44), allergic rhinitis (aHR, 1.29; 95% CI, 1.13–1.49), thyroid diseases (hyperthyroidism [aHR, 1.42; 95% CI, 1.14–1.77], hypothyroidism [aHR, 1.19; 95% CI, 1.01–1.41], and thyroiditis [aHR, 1.35; 95% CI, 1.08–1.69]), non-melanoma skin cancer (aHR, 2.33; 95% CI, 1.00–5.44), and vitamin D deficiency (aHR, 1.23; 95% CI, 1.03–1.47) were higher in patients with LPP. Patients with LPP had a higher mortality rate than controls (aHR, 1.30; 95% CI, 1.04–1.61), although the risk was not significant after adjusting for comorbidities (aHR, 1.08; 95% CI, 0.87–1.34). Conclusions Patients with LPP had a higher risk of various diseases following LPP diagnosis. Close follow-up is needed to optimize comprehensive patient care.
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