(PO-4350) Clinical Burden And Healthcare Resource Utilization In Patients With Generalized Pustular Psoriasis: A Claims Database Study
Monday, September 14, 2020
Nirali Kotowsky, Ran Gao, David Singer, Elizabeth M Garry and Amanda K Golembesky
Background: Generalized pustular psoriasis (GPP) is a rare, severe, potentially life-threatening systemic disease, characterised by recurrent acute flares consisting of disseminated erythematous skin rash with sterile neutrophil-filled pustules. To date, there is little real-world evidence characterising GPP patients.
Objectives: This study describes the clinical burden and healthcare resource utilization (HCRU) in patients with GPP in the USA compared to those with psoriasis vulgaris (PsO) to understand and evaluate unmet needs in this poorly understood patient population.
Methods: Patients were diagnosed as having GPP or PsO if they had ≥1 inpatient or 2 outpatient diagnostic claim(s) for ICD-10 L40.1 or L40.0 respectively, separated by 30 to 365 days. All analyses were conducted via the Aetion Evidence Platform™ v3.17, using 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, and the PsO cohort provided context to the GPP burden of disease and HCRU. Patient characteristics during the 180-day baseline and all-cause HCRU calculated for each visit type (inpatient, outpatient and emergency department [ED]) among 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 1175 patients with GPP and 75,494 with PsO were identified at baseline; 637 GPP and 38,950 PsO patients had ≥12 months’ FU. At baseline, patients with GPP were more likely to suffer from psoriatic arthritis (GPP: 20.6%; PsO: 6.4%; MC: <0.1%), anxiety (GPP: 9.0%; PsO: 6.0%; MC: 5.1%), and depression (GPP: 7.0%; PsO: 4.0%; MC: 3.1%) compared with the PsO cohort and the MC. GPP patients also had more outpatient visits than the PsO cohort and MC (median [interquartile range]; GPP: 17.0 [9.0, 32.0]; PsO: 14.0 [8.0, 25.0]; MC: 7.0 [3.0, 15.0]). More GPP patients had inpatient (GPP: 12.2%; PsO: 6.5%; MC: 6.2%) and ED visits (GPP: 24.6%; PsO: 20.0%; MC: 18.0%) and required longer hospitalisations (GPP: 5.0 [3.0, 12.0]; PsO: 4.0 [3.0, 7.0]; MC: 4.0 [3.0, 7.0] days) during the 12-month-FU compared to the PsO cohort and MC.
Conclusions: These findings suggest that patients with GPP have a higher clinical burden and more HCRU than those with PsO or in the MC, highlighting an unmet need in this patient population.