Singer David, Thompson-Leduc Philippe, Ma Siyu, Gupta Deepshekhar, Cheng Wendy Y, Sendhil Selvam R, Sundar Manasvi, Hagopian Ella, Stempniewicz Nikita, Duh Mei Sheng, Poston Sara
GSK, US Health Outcomes and Epidemiology, Vaccines, FMC Tower Suite 1700, 2929 Walnut Street, Philadelphia, PA19104, USA.
Analysis Group, Inc., Montreal, QC, Canada.
Dermatol Ther (Heidelb). 2023 Nov;13(11):2649-2668. doi: 10.1007/s13555-023-00988-y. Epub 2023 Sep 22.
Patients with psoriasis (PsO) are at increased risk of herpes zoster (HZ), but recent data on the incidence of HZ among patients with PsO and the impact of HZ on healthcare resource use (HRU) and costs for patients with PsO have not been described.
This retrospective, longitudinal, cohort study estimated HZ incidence in cohorts of adults with vs without PsO (PsO + vs PsO-) and HRU and costs among those with PsO, with vs without HZ (PsO + /HZ + vs PsO + /HZ-) using Optum's de-identified Clinformatics Data Mart Database during 2015-2020. Patients with psoriatic arthritis were excluded from all four cohorts. Comparisons between cohorts used generalized linear models to adjust outcomes based on various baseline characteristics.
The incidence rate of HZ was significantly higher in the PsO + (n = 144,115) vs PsO- (n = 23,837,237) cohorts at 11.35 vs 7.67 per 1000 patient-years; adjusted incidence rate ratio (aIRR): 1.21, 95% confidence interval (CI): 1.16-1.25. HRU (outpatient, emergency department, and inpatient) was significantly higher in the PsO + /HZ + (n = 1859) vs PsO + /HZ- (n = 78,664) cohorts during 1 month and 3 months after HZ diagnosis (e.g., outpatient visits during month: 2.83 vs 1.30 per patient; aIRR: 1.96; 95% CI 1.86-2.06). Mean all-cause costs were also significantly higher in the PsO + /HZ + vs PsO + /HZ- cohort during both month ($5020 vs $2715 per patient; adjusted cost difference: $1390; 95% CI $842-$1964) and 3 months ($12,305 vs $8256; adjusted cost difference: $1422; 95% CI $280-$2889) after HZ diagnosis.
These findings show the increased incidence of HZ among patients with PsO and the clinical and economic burdens of HZ in this population. Considering the high prevalence of PsO, insights into the impact of HZ in these patients provide valuable evidence to inform clinical decision-making.
银屑病（PsO）患者发生带状疱疹（HZ）的风险增加，但关于PsO患者中HZ的发病率以及HZ对PsO患者医疗资源使用（HRU）和成本影响的最新数据尚未见报道。
这项回顾性纵向队列研究使用Optum的去识别化临床信息数据集市数据库，估计了2015 - 2020年期间患有和未患有PsO的成年人群体（PsO+与PsO-）中HZ的发病率，以及患有PsO且发生或未发生HZ的人群（PsO+/HZ+与PsO+/HZ-）的HRU和成本。银屑病关节炎患者被排除在所有四个队列之外。队列之间的比较使用广义线性模型根据各种基线特征调整结果。
PsO+队列（n = 144,115）中HZ的发病率显著高于PsO-队列（n = 23,837,237），分别为每1000患者年11.35例和7.67例；调整后的发病率比（aIRR）：1.21，95%置信区间（CI）：1.16 - 1.25。在HZ诊断后的1个月和3个月内，PsO+/HZ+队列（n = 1859）的HRU（门诊、急诊科和住院）显著高于PsO+/HZ-队列（n = 78,664）（例如，第1个月的门诊就诊次数：每位患者2.83次 vs 1.30次；aIRR：1.96；95% CI 1.86 - 2.06）。在HZ诊断后的第1个月（每位患者5020美元 vs 2715美元；调整后的成本差异：1390美元；95% CI 8
