(PO-4416) Clinical Burden And Healthcare Resource Utilization In Patients With Palmoplantar Pustulosis: A Claims Database Study
Monday, September 14, 2020
Nirali Kotowsky, Ran Gao, David Singer, Elizabeth M Garry and Amanda K Golembesky
Background: Palmoplantar pustulosis (PPP) is a chronic, debilitating, painful inflammatory skin disease characterised by localised, sterile pustules on the palms of the hands and soles of the feet. PPP may persist for decades, substantially affecting patients’ quality of life. To date, there is little real-world evidence characterising patients with PPP.
Objectives: By understanding the burden of disease in this population, targeted interventions that improve patients’ quality of life should be developed. This study describes the clinical burden and healthcare resource utilization (HCRU) in patients with PPP in the USA to evaluate previously unmet needs in this poorly understood patient population.
Methods: Patients were diagnosed as having PPP if they had ≥1 inpatient or 2 outpatient diagnostic claim(s) for ICD-10 L40.3, separated by 30 to 365 days. All analyses were conducted via the Aetion Evidence Platform™ v3.17, using the IBM® MarketScan® Research Databases. The study period was from 1 October, 2015 to 30 September, 2018, with the first diagnostic claim marking the index date. A general population matched cohort (MC) of 4:1, based on age and sex, that excluded subjects with any psoriasis other than psoriatic arthritis was generated for context. Patient characteristics during the 180-day baseline and all-cause HCRU calculated for each visit type (inpatient, outpatient and emergency department [ED]) in patients with 12 months of follow-up (FU) were analysed. All analyses were descriptive in nature; no formal comparisons were conducted.
Results: A total of 1579 patients with PPP were identified at baseline, and 807 had ≥12 months’ FU. At baseline, patients with PPP were more likely to have a diagnosis of hyperlipidaemia (PPP: 21.3% vs MC: 11.4%), anxiety (PPP: 6.4% vs MC: 4.9%) and depression (PPP: 5.3% vs MC: 3.1%) compared with the MC. During the 12-month FU, 507 patients with PPP (62.8%) were treated with a systemic therapy (biologic or non-biologic). Compared with the MC, patients with PPP had more outpatient visits (median [interquartile range]; PPP: 17.0 [10.0, 30.0] vs 7.0 [3.0, 16.0]) and a higher proportion had inpatient (9.4% vs 6.5%) and ED (22.4% vs 17.7%) visits during the 12-month FU. The length of hospitalisation was similar between patients with PPP and the MC (4.0 [3.0, 6.0] vs 4.0 [3.0, 6.0] days) during the 12-month FU.
Conclusions: Patients with PPP tend to have higher levels of comorbidities and higher HCRU compared with the MC, highlighting an unmet need among these patients.