Lebwohl M, Medeiros R A, Mackey R H, Harrold L R, Valdecantos W C, Flack M, Golembesky A K, Kotowsky N, Strober B
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Biostatistics, CorEvitas, LLC, Waltham, MA, USA.
J Psoriasis Psoriatic Arthritis. 2022 Apr;7(2):71-78. doi: 10.1177/24755303221079814. Epub 2022 Mar 11.
Generalized pustular psoriasis (GPP) is a rare, systemic disease characterized by persistent or recurrent flares of painful neutrophilic pustules. There is limited real-world evidence characterizing patients with GPP. To establish the distinguishing characteristics of GPP relative to plaque psoriasis, and help inform future treatment decisions and improve patient outcomes. North American adults with GPP or plaque psoriasis (without pustules) identified from CorEvitas' Psoriasis Registry were included in this dataset. Registry enrollment data, including patient sociodemographics, disease characteristics, medication use, and patient-reported outcome measures were compared for patients with GPP vs those with plaque psoriasis. This study was descriptive, and no hypothesis tests were performed. In this sample, patients with GPP (N = 60) reported greater median (interquartile range) pain (20 [3-62] vs 5 [0-35]), fatigue (44 [15-73] vs 20 [4-50]), and itch (59 [10-85] vs 22 [5-70]) than those with plaque psoriasis (N = 4894). Descriptively, patients with GPP also reported more anxiety and depression (EQ-5D-3L: 38% vs 26%) and had more treatment experience (≥2 previous systemics: 15% vs 7%). A greater degree of symptom severity and impact on quality of life was reported by patients with GPP compared with plaque psoriasis in this sample. Importantly, patients with GPP had more treatment experience, suggesting that current treatment options do not adequately resolve the disease-highlighting the need to develop more effective GPP treatments.
泛发性脓疱型银屑病（GPP）是一种罕见的全身性疾病，其特征为疼痛性中性粒细胞脓疱持续或反复发作。关于GPP患者的真实世界证据有限。为了确定GPP相对于斑块状银屑病的区别特征，并为未来的治疗决策提供信息，改善患者预后。从CorEvitas银屑病登记处识别出的北美成年GPP或斑块状银屑病（无脓疱）患者被纳入该数据集。比较了GPP患者与斑块状银屑病患者的登记入组数据，包括患者的社会人口统计学、疾病特征、用药情况以及患者报告的结局指标。本研究为描述性研究，未进行假设检验。在该样本中，GPP患者（N = 60）报告的中位（四分位间距）疼痛（20 [3 - 62] 对比 5 [0 - 35]）、疲劳（44 [15 - 73] 对比 20 [4 - 50]）和瘙痒（59 [10 - 85] 对比 22 [5 - 70]）均高于斑块状银屑病患者（N = 4894）。从描述来看，GPP患者还报告了更多的焦虑和抑郁（EQ - 5D - 3L：38% 对比 26%），并且有更多的治疗经历（≥2次既往全身治疗：15% 对比 7%）。与该样本中的斑块状银屑病患者相比，GPP患者报告的症状严重程度更高，对生活质量的影响更大。重要的是，GPP患者有更多的治疗经历，这表明当前的治疗方案未能充分解决该疾病——凸显了开发更有效GPP治疗方法的必要性。
