Clinical Characteristics and HealthCare Resource Utilization in Patients With Generalized Pustular Psoriasis: Real-World Evidence From a Large Claims-Based Dataset

Background: Generalized pustular psoriasis (GPP) is a rare, severe neutrophilic skin disease with significant unmet clinical need. Historically, GPP has not been well characterized; however, the advent of the International Classification of Diseases, 10th revision, has made it possible to more accurately characterize patients with GPP. Objective: To describe the characteristics and estimate the burden of disease in patients with GPP compared with those with plaque psoriasis. Methods: A retrospective study was conducted using a US administrative claims database, Optum® Clinformatics® Data Mart, between October 1, 2015, and March 31, 2019. Patients with at least 1 inpatient or 2 outpatient diagnosis codes for GPP (L40.1) or psoriasis vulgaris (L40.0) were included. The main outcome measures included the percentage of individuals with comorbidities, medication use, and healthcare resource utilization (HCRU), which were compared between patients with GPP and those with plaque psoriasis and a general population comparator control cohort. Results: Overall, 1,669 patients with GPP were identified at baseline; most patients were female (67.6%). Patients with GPP had more comorbidities than those with plaque psoriasis, specifically metabolic disorders: hyperlipidemia and type 2 diabetes. Medication use for patients with GPP differed from those with plaque psoriasis—patients with GPP required more frequent use of antihypertensives and antibiotics than those with plaque psoriasis. Patients with GPP also had higher HCRU than those with plaque psoriasis. Conclusion: Although this study has limitations, it shows that patients with GPP have a high burden of illness that differs from patients with plaque psoriasis.