Clinical Characteristics and HealthCare Resource Utilization in Patients With Generalized Pustular Psoriasis: Real-World Evidence From a Large Claims-Based Dataset

Abstract

Background: Generalized pustular psoriasis (GPP) is a rare, severe neutrophilic skin disease with significant unmet clinical need. Historically, GPP has not been well characterized; however, the advent of the International Classification of Diseases, 10th revision, has made it possible to more accurately characterize patients with GPP. Objective: To describe the characteristics and estimate the burden of disease in patients with GPP compared with those with plaque psoriasis. Methods: A retrospective study was conducted using a US administrative claims database, Optum® Clinformatics® Data Mart, between October 1, 2015, and March 31, 2019. Patients with at least 1 inpatient or 2 outpatient diagnosis codes for GPP (L40.1) or psoriasis vulgaris (L40.0) were included. The main outcome measures included the percentage of individuals with comorbidities, medication use, and healthcare resource utilization (HCRU), which were compared between patients with GPP and those with plaque psoriasis and a general population comparator control cohort. Results: Overall, 1,669 patients with GPP were identified at baseline; most patients were female (67.6%). Patients with GPP had more comorbidities than those with plaque psoriasis, specifically metabolic disorders: hyperlipidemia and type 2 diabetes. Medication use for patients with GPP differed from those with plaque psoriasis—patients with GPP required more frequent use of antihypertensives and antibiotics than those with plaque psoriasis. Patients with GPP also had higher HCRU than those with plaque psoriasis. Conclusion: Although this study has limitations, it shows that patients with GPP have a high burden of illness that differs from patients with plaque psoriasis.

Healthcare Resource Utilization and Baseline Characteristics of Patients With Generalized Pustular Psoriasis: Real-World Results From a Large US Database of Multiple Commercial Medical Insurers

“…10,11 Notably, a greater prevalence of hyperlipidemia in patients with GPP than in those with plaque psoriasis was also observed in the Optum ® study. 6 It is possible that these comorbidities are associated with the defective inflammatory pathways underlying the pathogenesis of GPP. The systemic inflammation in GPP could be perpetuated further by the increased deposition of low-density lipids in hyperlipidemia, which triggers the interleukin-1b inflammatory pathway.…”

“…In contrast to the Optum ® study, 6 the IBM ® MarketScan ® Research Database includes only a small proportion of data from patients receiving Medicare Advantage (though includes a higher proportion of Medicare Supplemental data) and comprises person-specific data from mostly employed, commercially insured individuals. Collectively, patients had a lower mean age in this study than in the Optum ® study.…”

“…Both Optum ® and IBM ® MarketScan ® studies were conducted using identical methodology; please refer to the Optum ® study for full details. 6 The IBM ® MarketScan ® Research Database comprises the IBM ® MarketScan ® Commercial Database, including *59 million employed individuals aged <65 years and their dependents, and the IBM ® MarketScan ® Medicare Supplemental Database, including *5 million retired individuals with Medicare Supplemental insurance paid by their previous employers. Using International Classification of Diseases, 10 th revision (ICD-10), codes, as well as Current Procedural Terminology (v4) and Healthcare Common Procedure Coding System codes, diagnostic codes for comorbidities and diagnostic claims during inpatient, outpatient, and emergency department (ED) visits were identified between October 1, 2015 and September 30, 2018.…”

“…5 Two independent studies exploring the burden of disease and healthcare resource utilization (HCRU) in patients with GPP were conducted using the IBM ® MarketScan ® Research Database and the Optum ® Clinformatics ® Data Mart. 6 Here, we report the findings from the IBM ® MarketScan ® analysis, whereby commercial insurance and Medicare data have permitted the identification of differences in the demographics, comorbidities, concurrent medication use, and HCRU of patients with GPP compared with those with plaque psoriasis and a cohort of the general population in a real-world setting in the USA.…”

Diversity in the clinical presentation of generalized pustular psoriasis (GPP): A series of case vignettes from around the world

“…Overall, we hope that the key learnings from this case series may support physicians in identifying and managing patients with this rare and multifaceted disease that can affect patients both physically and psychologically. 19,[23][24][25]…”