Health Care Utilization Patterns and Costs for Patients With Hidradenitis Suppurativa

Kirby, Joslyn S.; Miller, Jeri L.; Adams, David R.; Leslie, Douglas L.

doi:10.1001/jamadermatol.2014.691

Cited by 92 publications

(121 citation statements)

References 35 publications

(30 reference statements)

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“…Although we described a frequency of other morbidities and risk factors lower than other studies, it was higher when compared to another study using a similar administrative database, except for hypertension [23] . In fact, the ranking of those morbidities and risk factors described by us was similar to the ones of other studies [12,20,21,27] .…”

Section: Discussioncontrasting

confidence: 95%

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Hospitalisations with Hidradenitis Suppurativa: An Increasing Problem That Deserves Closer Attention

Santos¹,

Lisboa²,

Lanna³

et al. 2016

Dermatology

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Background/Aims: Hidradenitis suppurativa (HS), a chronic inflammatory skin disease of the hair follicle, can lead to scarring and disability. With an estimated European prevalence of 1%, few epidemiological studies of HS have been performed, and none focused on hospitalisations. We aimed to study the time trends of HS hospitalisations and to evaluate the demographic characteristics, hospital incidence rate, readmissions, length of stay, comorbidities and risk factors of hospitalised HS patients. Methods: We performed a retrospective observational study using a national administrative database in Portugal, with discharges between 2000 and 2014. All the inpatients aged 5 years or more with a diagnosis of HS were included. Variables analysed were age, sex, admission and discharge date, discharge outcome and diagnoses. Results: A total of 1,177 patients were hospitalised in this time period (48 were aged 18 years or younger) with a male-to-female ratio of 1:1.17. There was a hospital incidence rate of 0.83 patients with HS per 100,000 person-years (95% CI = 0.78-0.88). The age group with the highest incidence rate was 20-29 years among women and 40-49 years among men. We recorded an increasing trend in the number of new hospitalised patients and in the hospital incidence rate of HS. Tobacco was the most common comorbidity/risk factor. Eighty-three percent of our population underwent HS surgery. Conclusion: This hospital-based incidence study showed that admission for HS is increasing and that the majority of the HS inpatients were surgical cases. In the future, prospective studies will be important to assess risk factors for hospitalisations and complications.

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Section: Discussioncontrasting

confidence: 95%

“…Its association with HS had already been pointed out, though other studies described a prevalence between 17.8 and 92.2% [3,12,[20][21][22][27][28][29][30] , if we exclude that from Kirby et al [23] with a prevalence of 0.5%.…”

Section: Discussionmentioning

confidence: 82%

Hospitalisations with Hidradenitis Suppurativa: An Increasing Problem That Deserves Closer Attention

Santos¹,

Lisboa²,

Lanna³

et al. 2016

Dermatology

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“…Additional references were identified from reference lists. After application of inclusion and exclusion criteria, 12 studies were included in the systematic review and meta‐analysis (Table ), of which 5 studies had adjusted effect sizes available for extraction. The included study characteristics and demographics of these studies are summarized in Table .…”

Section: Resultsmentioning

confidence: 99%

Hidradenitis suppurativa and diabetes mellitus: updated systematic review and adjusted meta‐analysis

2019

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Summary Background Hidradenitis suppurativa (HS) is a debilitating and distressing chronic inflammatory skin disease. There is also evolving evidence supporting the association between HS and cardiovascular risk factors, including smoking, obesity, hyperlipidaemia and metabolic syndrome. Notably, these are clinical features and risk factors that are closely associated with type 2 diabetes mellitus (DM). Aims We performed a pooled adjusted meta‐analysis of comparative studies to investigate the relationship between HS and DM. Methods A systematic review and meta‐analysis was performed according to recommended Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. OR was used as the summary effect size. Results From pooled analysis of unadjusted data from 12 studies, we found a significantly higher proportion of DM in HS cases compared with non‐HS healthy controls (16.1% vs. 15.7%; OR = 2.17; 95% CI 1.85–2.55; P < 0.001). Adjusted effect sizes from five studies were also pooled. A significantly higher proportion of DM was found for HS compared with healthy controls, although the effect size was attenuated compared with unadjusted analyses (OR 1.69; 95% CI 1.50–1.91; P < 0.001). Conclusions To our knowledge, our systematic review and meta‐analysis is the first to pool adjusted effect sizes. We found that HS was associated with a 1.69‐fold increased odds of diabetes; however, the absolute risk difference was small (16.1% vs. 15.7%) and is probably not clinically relevant. Treating clinicians should be aware of this association, but there may not be an urgent need to perform screening for impaired glucose tolerance or diabetes.

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“…Even though biologics are seldom curative in HS, they can suppress the symptoms and can often be given for a prolonged period, making them a good treatment option for chronic HS. The negative aspects of biologics are the cost and that reimbursement is not covered by all insurance companies [63].…”

Section: Biologicsmentioning

confidence: 99%

An Update on Medical Treatment Options for Hidradenitis Suppurativa

Deckers

Prens

2015

Drugs

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurrent inflammatory nodules mostly located in the armpits and groin. Over the years multiple treatments for HS have been proposed; however, to date a cure is still lacking. In this update we provide an overview of most drug treatments reported on for HS, where possible with their mode of action and side effects. In mild cases, clindamycin lotion or resorcinol cream have proven effective. Tetracyclines are a first-line systemic option in more widespread or severe cases, followed by the combination of clindamycin and rifampicin. However, the recurrence rate is high after discontinuation of clindamycin plus rifampicin combination therapy. Long-term treatment with retinoids, especially acitretin is feasible, although teratogenicity has to be taken into account in females of reproductive age. Multiple antiinflammatory drugs have been suggested for HS, such as dapsone, fumarates or cyclosporine. However, their effectiveness in HS is based on small case series with varying results. If most common treatments have failed, biologics (e.g., infliximab or adalimumab) are the next step. Although not addressed in this review, surgical interventions are often needed to achieve remission. Key PointsHidradenitis suppurativa (HS) is a chronic inflammatory skin disease without a cure.Antibiotics (topical or oral) are often the first treatment option for HS.In cases of more extensive or therapy-resistant HS, biologicals (e.g., infliximab or adalimumab) are a good therapeutic option.

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Health Care Utilization Patterns and Costs for Patients With Hidradenitis Suppurativa

Cited by 92 publications

References 35 publications

Hospitalisations with Hidradenitis Suppurativa: An Increasing Problem That Deserves Closer Attention

Hospitalisations with Hidradenitis Suppurativa: An Increasing Problem That Deserves Closer Attention

Hidradenitis suppurativa and diabetes mellitus: updated systematic review and adjusted meta‐analysis

An Update on Medical Treatment Options for Hidradenitis Suppurativa

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