Real-World Findings on the Characteristics and Treatment Exposures of Patients with Hidradenitis Suppurativa from US Claims Data

Abstract

Introduction Hidradenitis suppurativa (HS) is a chronic, debilitating, and painful inflammatory skin disease that significantly and negatively impacts patients’ quality of life. The prevalence of HS in the USA is estimated to be 0.10%, with worldwide reports suggesting a prevalence closer to 1%. There is limited real-world evidence available on the care of patients with HS. We aimed to evaluate the trends in clinical care and treatment in the patient population with HS in the USA in a real-world setting. Methods A cohort study was conducted using claims data from IBM MarketScan Databases, including the US Commercial Claims and Encounters with Medicare Supplemental and Coordination of Benefits (CCAE+MDCR) database and IBM US Medicaid database. Results The annual prevalence of HS increased from 0.06% (2008) to 0.14% (2017), and from 0.17% (2008) to 0.31% (2017) among CCAE+MDCR and Medicaid patients, respectively. Dermatologist visits increased from 31.9% (2008) to 47.8% (2019) in CCAE+MDCR patients, and decreased from 10.9% (2008) to 8.5% (2018) in Medicaid patients. Opioid use decreased from 45.4% (2008) to 25.5% (2019) among CCAE+MDCR patients, and from 71.3% (2008) to 48.1% (2018) among Medicaid patients. Only 8.4% of CCAE+MDCR patients and 5.8% of Medicaid patients were exposed to any biologic in 2018. Conclusions Improved care and treatment of HS over the last decade, including the emergence of new treatments, have been accompanied by an increase in awareness and reported prevalence of the disease. However, there are still gaps in access to dermatologic care and low utilization of biologic therapies among patients with HS. Infographic

Navigating the Multidimensional Impact of Living with Hidradenitis Suppurativa: An In-Depth Netnographic Study on Social Media Platforms

“…Interestingly, the heavy reliance on over-the-counter medicines noted in this study indicates that patients may be attempting to self-manage their symptoms, likely because of the lack of standardized treatments or poor access to healthcare. This is in line with studies demonstrating that HS is often undertreated, despite the significant burden it imposes [ 44 , 46 ].…”

“…Our insights reveal a complex journey for patients with HS, from symptom onset to diagnosis and treatment, which often involves delays [ 42 , 43 ]. The treatment landscape for HS, as depicted in this study, is multifaceted, involving diverse pharmacological, non-pharmacological interventions, and procedural approaches [ 44 ]. This corresponds with a wealth of existing literature suggesting that HS management must be individualized and encompass both medical and surgical treatments [ 45 ].…”

“…Within the realm of non-pharmacological oral interventions, herbal medicines are reported frequently. This usage could be attributed to perceptions of fewer side effects or as alternatives when conventional treatments are deemed ineffective or inaccessible [ 44 ]. This behavior is not exclusive to HS and has been seen in other chronic illnesses in general [ 47 ].…”

LncRNA microarray profiling identifies novel circulating lncRNAs in hidradenitis suppurativa

“…Of note, obesity represents a primary risk factor for hidradenitis, although the exact of the association between the two disorders is not yet well understood. The chronic inflammatory state established in patients with obesity likely plays a role in contributing to the susceptibility to hidradenitis as obesity generates an imbalance in a plethora of cytokines and adipokines, contributing to dysregulation in the immune system, thus participating in the etiopathogenesis of hidradenitis ( 20 , 21 ).…”

Characteristics and treatment pathways in pediatric and adult hidradenitis suppurativa: An examination using real world data

“… 14 HS patients receiving biologic therapies have reported reductions in the count of abscess and nodules, reductions in pain score, and reductions of the impact of HS on daily life. 15 There have been very few adequately powered studies conducted to study the efficacy of biologics in HS subjects 16 and studies using real world data have been limited in studying 17 this recently approved drug class for HS treatment.…”