Generalized pustular psoriasis in Brazil: A public claims database study

Abstract

Background Generalized pustular psoriasis (GPP) is a rare and severe phenotype of psoriasis characterized by sudden outbreak of widespread coalescent sterile pustules associated with a spectrum of systemic symptoms. Objective We aimed to describe the epidemiology and treatment of GPP in Brazil from the public health care system perspective. Methods This was a retrospective public claims database study, using outpatient and inpatient databases, with information from January 2018 to August 2020, based on records of health resource utilization by patients with GPP. Outpatient treatment regimens and fatal inpatient outcomes were described. Results In total, 1458 outpatients of all ages were identified, of whom 53% were women. We estimated the GPP prevalence in Brazil to be between 0.7 and 0.9 per 100,000. Acitretin was the most commonly dispensed drug. Of all the outpatients, 769 outpatients could be tracked in the inpatient database, and 151 had hospital admissions during the study period. Of them, 5.3% had a fatal outcome during hospitalization. A primary skin condition or an infection was the most frequent hospitalization cause. Limitation The International Classification of Diseases codes for GPP and psoriasis have not been previously validated in this context. Conclusion GPP is a rare disease in Brazil and affects individuals of all ages and both sexes. Hospitalizations and disease-related deaths highlight the need for its prompt diagnosis, close medical follow-up, and effective treatment.

Epidemiological survey of patients with pustular psoriasis in the Japanese Society for Psoriasis Research from 2017 to 2020

“…In contrast, the male: female ratio was 2.7:1 in a retrospective study analyzing Chinese patients, 14 and 1:2 in a retrospective study analyzing Malaysian patients 15 . In Brazil, a public claims database study reported 1458 cases of pustular psoriasis, of which 53% were female 16 . The predominance of males or females may vary with the country.…”

“…In a retrospective study using the Japanese Medical Data Vision claims database, 50.0% of patients were aged 65 years and older 13 . In contrast, the proportion of the patients increased gradually and the peak proportions of both male and female patients were 51–60‐year‐old group in a study from Brazil 16 . There may be more elderly patients than young patients in Japan.…”

“… 15 In Brazil, a public claims database study reported 1458 cases of pustular psoriasis, of which 53% were female. 16 The predominance of males or females may vary with the country.…”

“… 13 In contrast, the proportion of the patients increased gradually and the peak proportions of both male and female patients were 51–60‐year‐old group in a study from Brazil. 16 There may be more elderly patients than young patients in Japan. Moreover, there were more elderly patients with pustular psoriasis than in the past JSPR surveys of psoriasis.…”

Generalized pustular psoriasis: A global Delphi consensus on clinical course, diagnosis, treatment goals and disease management

“…Generalized pustular psoriasis (GPP; von Zumbusch type) is a rare autoinflammatory skin disease characterized by widespread eruption of sterile, neutrophilic pustules 1,2 . The prevalence of GPP varies between studies and countries, with reports of 0.02 per 10,000 people in France, 0.07–0.09 per 10,000 in Brazil, 0.15 per 10,000 in Sweden, 0.2 per 10,000 in Japan, 0.9 per 10,000 in the USA, 1.1 per 10,000 in South Korea and 1.4 per 10,000 in Germany 3–7 …”