Noe Megan H, Lavasani Layla, Rasouliyan Lawrence, Laouri Marianne, Rhoads Jamie L W
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, CT, USA.
J Psoriasis Psoriatic Arthritis. 2025 Jan 25:24755303251317193. doi: 10.1177/24755303251317193.
Generalized pustular psoriasis (GPP) is a rare, chronic, often unpredictable, severe multisystemic autoinflammatory skin disease from which patients can experience flares, episodes of widespread eruptions of painful, sterile pustules often accompanied by systemic symptoms. The impact of GPP flares and underlying GPP severity on the healthcare resource utilization (HCRU) is not well characterized.
To quantify HCRU among US GPP patients by flare status and underlying severity.
Outpatient electronic health record (EHR) data (2017-2023) from the OMNY Health platform were linked with claims. Patients were indexed at first EHR GPP diagnosis code and followed for 1 year. GPP flares were identified from a previously developed algorithm. All-cause hospitalizations, emergency department/urgent care (ED/UC), and outpatient visits were summarized by flare status and underlying severity. Pharmacy and total gross charges were described by number of flares.
A total of 335 patients were included. Patients who flared in the follow-up period (n = 205) had more hospitalizations than patients who did not flare (n = 130; 12.2% vs 6.9%; mean: 0.26 vs 0.09). ED/UC visits were similar between groups (22.9% vs 27.7%; mean: 0.54 vs 0.45), while outpatient visits were greater among patients who did not flare (69.8% vs 78.5%; mean: 5.37 vs 6.56). For patients with 0, 1, and ≥2 flares with HCRU, mean pharmacy charges ($19,887, $25,180, and $57,674, respectively) and total gross charges ($29,196, $40,079, and $52,940, respectively) increased monotonically.
GPP patients who flared and had more severe disease had greater HCRU and charges.
泛发性脓疱型银屑病（GPP）是一种罕见的、慢性的、通常不可预测的严重多系统自身炎症性皮肤病，患者可能会出现病情发作，即广泛爆发疼痛性无菌脓疱，常伴有全身症状。GPP发作及潜在的GPP严重程度对医疗资源利用（HCRU）的影响尚未得到充分描述。
按发作状态和潜在严重程度对美国GPP患者的HCRU进行量化。
来自OMNY Health平台的门诊电子健康记录（EHR）数据（2017 - 2023年）与理赔数据相关联。患者以首次EHR中的GPP诊断代码为索引，并随访1年。GPP发作通过先前开发的算法确定。全因住院、急诊科/紧急护理（ED/UC）和门诊就诊情况按发作状态和潜在严重程度进行汇总。药房费用和总费用按发作次数进行描述。
共纳入335例患者。随访期间发作的患者（n = 205）比未发作的患者（n = 130；12.2%对6.9%；平均值：0.26对0.09）有更多的住院次数。两组之间的ED/UC就诊情况相似（22.9%对27.7%；平均值：0.54对0.45），而未发作患者的门诊就诊次数更多（69.8%对78.5%；平均值：5.37对6.56）。对于发作次数为0、1和≥2次的HCRU患者，平均药房费用（分别为19,887美元、25,180美元和57,674美元）和总费用（分别为29,196美元、40,079美元和52,940美元）呈单调增加。
发作且病情更严重的GPP患者的HCRU和费用更高。
