Generalized pustular psoriasis lacks advanced treatment options
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An unmet need exists to treat generalized pustular psoriasis and its flares, leading many patients to seek emergency or inpatient treatment, according to a study.
“[Generalized pustular psoriasis (GPP)] flares are debilitating for patients and often require emergency department or acute care,” Wendell C. Valdecantos, MD, executive director of clinical development and medical affairs for Boehringer Ingelheim and one of the study’s authors, told Healio. “Our findings reflect the lack of consensus on the standard of care for GPP and highlights the significant unmet need in the current treatment of this condition.”
A retrospective cohort study of adult patients with GPP, as identified by electronic health records, was conducted in this research. Flare episodes were characterized based on frequency, care setting where they were identified, specialist treating the flare, symptoms and the types of treatment administered.
Of 1,535 patients with GPP, 271 had a total of 513 documented flares during the study time period.
Documented flares were more likely in patients with Medicare and Medicaid, as compared with those with commercial insurance, and those with flares had a higher comorbidity burden.
GPP flares were identified in outpatient settings for 53% of the flares, with 36% being identified in inpatient settings, 9% in EDs and 2% in other settings.
Those identified in an outpatient setting were identified by dermatologists 73% of the time, rheumatologists 10% of the time and primary care specialists 9% of the time.
Topical corticosteroids were prescribed for 35% of the flares, making it the most common treatment during a flare, followed by oral dermatologic treatments (methotrexate, cyclosporine or tacrolimus) in 13% of flares and oral corticosteroids in 11%. Opioids were prescribed in 21% of flare episodes.
Advanced treatments such as biologics or JAK inhibitors were rarely prescribed for this indication.
“GPP flares are debilitating for patients, and often require emergency department or acute care. Before, during and after flare episodes, health care professionals — largely in the emergency department and inpatient setting — initiate treatment with corticosteroids, topical therapies and opioids, among others,” Valdecantos said. “Advanced treatments are very rarely used despite the severity of the disease indicating a strong need for new, innovative options to better treat those living with GPP.”
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