Biologic treatments demonstrate better outcomes of generalized pustular psoriasis: Study

Generalized pustular psoriasis (GPP) is a dreadful skin condition, also referred to as 'psoriasis'. It is an abnormal and uncontrolled inflammatory condition, which instead of benefiting the body damages the body's vital tissues and organs. These patients suffer from repeated and regular episodes of GPP, wherein large areas of their skin become red, inflamed, and develop small pus-filled blisters called 'pustules'. Additionally, the patient may also get a fever, feel tired (fatigue), have muscle weakness, or their WBCs may increase. However, generalized pustular psoriasis is quite rare, so there are very limited studies reporting treatments and outcomes for large numbers of patients.

A study was conducted by Miyachi H et. al to report treatments and outcomes within a large cohort of patients suffering from generalized pustular psoriasis and admitted to the hospital.

The researchers utilized a Japanese national inpatient care records, and selected a total of 1516 patients with generalized pustular psoriasis with a mean age of 66 years, who were admitted to a hospital between July 2010 and March 2019. Out of which Fifty patients (3.3%) were admitted to the intensive care unit (ICU), 125 (8.2%) required blood pressure support, and 63 (4.2%) had died. To investigate their characteristics, treatments, and outcomes, they further categorized the patients into three medication groups:

• Biologics (294 patients)
• Oral agents without biologics (948 patients)
• Systemic corticosteroids only (274 patients)

The findings of the study were as follows:

• Patients who received biologics were younger and had fewer comorbidities.
• In-hospital mortality and morbidity were lower in the biologics group as compared to the other two groups; mortality (1.0% [biologics group] vs 3.7% [oral-agents group] vs 9.1% [corticosteroids-only group]; P < .001) and morbidity (5.4% vs 8.2% vs 12%, respectively; P = .02).
• Also, in the biologics group, IL-17 inhibitor use increased over time, with in-hospital mortality and morbidity compared to those of tumor necrosis factor inhibitors.

The authors concluded that thus, biological treatments showed favorable outcomes compared with other treatments.

Reference:

A study titled, "Treatments and outcomes of generalized pustular psoriasis: A cohort of 1516 patients in a nationwide inpatient database in Japan" by Miyachi H et. al published in the Journal of American Academy of Dermatology.

https://doi.org/10.1016/j.jaad.2021.06.008