7 Giugno 2022
Hideaki Miyachi, Takaaki Konishi, Ryosuke Kumazawa, Hiroki Matsui, Sayuri Shimizu, Kiyohide Fushimi, Hiroyuki Matsue, Hideo Yasunaga

Treatments and outcomes of generalized pustular psoriasis: A cohort of 1516 patients in a nationwide inpatient database in Japan

JAAD 2022;86(6):1266-1274
  • La psoriasi pustolosa generalizzata è una patologia rara e ci sono pochi studi relativi al trattamento e agli obiettivi terapeutici su grandi gruppi di pazienti.
  • Nel presente studio i farmaci biologici hanno mostrato risultati favorevoli rispetto agli altri trattamenti.


Because generalized pustular psoriasis (GPP) is rare, there are few studies reporting treatments and outcomes for large numbers of patients.

To report treatments and outcomes in a large cohort of patients hospitalized with GPP.

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.

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.

Retrospective study design. Some patients received multiple medications.

Biologic treatments showed favorable outcomes compared with other treatments.

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