Treatments and outcomes of generalized pustular psoriasis: A cohort of 1516 patients in a nationwide inpatient database in Japan
Treatments and outcomes of generalized pustular psoriasis: A cohort of 1516 patients in a nationwide inpatient database in Japan
复制标题
DOI：
10.1016/j.jaad.2021.06.008
复制
发表时间：
2022-05-13
影响因子：
13.8
通讯作者：
Yasunaga, Hideo
中科院分区：
文献类型：
--
作者：
Miyachi, Hideaki;Konishi, Takaaki;Yasunaga, Hideo
背景：由于泛发性脓疱性银屑病(GPP)罕见，很少有研究报道大量患者的治疗和结果。目的：报道大量GPP住院患者的治疗和结果。方法：使用日本国家住院患者数据库，我们确定了2010年7月至2019年3月期间需要住院的1516名GPP患者。我们将患者分为3组：生物制剂组(294例)、非生物制剂口服制剂组(948例)和全身皮质类固醇激素组(274例)。结果：平均年龄66岁(四分位数范围52-77岁)。50名患者(3.3%)进入重症监护病房，125名(8.2%)患者需要血压支持，63名患者(4.2%)死亡。接受生物制剂治疗的患者更年轻，合并疾病也更少。生物制品组的住院死亡率较低(1.0%[生物制品组]vs3.7%[口服组]vs9.1%[仅使用皮质类固醇组]；P<；.001)，发病率也较低(分别为5.4%vs8.2%vs12%；P=0.02)。在接受生物制品治疗的患者中，IL-17抑制剂的使用随着时间的推移而增加，住院死亡率和发病率与肿瘤坏死因子抑制剂相当。限制：回溯性研究设计。部分患者接受多种药物治疗。结论：与其他治疗方法相比，生物治疗具有良好的疗效。
Background: Because generalized pustular psoriasis (GPP) is rare, there are few studies reporting treatments and outcomes for large numbers of patients.Objective: To report treatments and outcomes in a large cohort of patients hospitalized with GPP.Methods: Using a Japanese national inpatient database, we identified 1516 patients with GPP who required hospitalization between July 2010 and March 2019. We categorized patients into 3 medication groups: biologics (294 patients), oral agents without biologics (948 patients), and systemic corticosteroids only (274 patients). We investigated their characteristics, treatments, and outcomes.Results: Mean age was 66 years (interquartile range: 52-77 years). Fifty patients (3.3%) were admitted to the intensive care unit, 125 (8.2%) required blood pressure support, and 63 (4.2%) died. Patients who received biologics were younger and had fewer comorbidities. In-hospital mortality was lower in the biologics group (1.0% [biologics group] vs 3.7% [oral-agents group] vs 9.1% [corticosteroids-only group]; P < .001) as was morbidity (5.4% vs 8.2% vs 12%, respectively; P = .02). Among those who received biologics, IL-17 inhibitor use increased over time, with in-hospital mortality and morbidity comparable to those of tumor necrosis factor inhibitors.Limitations: Retrospective study design. Some patients received multiple medications.Conclusion: Biologic treatments showed favorable outcomes compared with other treatments.