Most patients with generalized pustular psoriasis flares receive no specific treatment: JAMA

According to a new study published in the Journal of American Medical Association there is a considerable unmet demand for the treatment of generalized pustular psoriasis (GPP) and associated flares, as indicated by patients requesting care in inpatient and emergency department settings, as well as a paucity of sophisticated therapies.

Aside from single-center case studies, nothing is known about widespread pustular psoriasis flares. Carla L. Zema and colleagues undertook this study to evaluate GPP flares and their management, as well as variations between patients with and without flares reported in US electronic health records (EHRs).

This retrospective cohort analysis includes adult patients with GPP found in Optum deidentified EHR data from July 1, 2015, to June 30, 2020. With no coded history of GPP for at least 6 months earlier, the index GPP diagnosis was the first occurrence in the EHR. An algorithm was used to identify flare events in the EHR based on diagnosis coding, care environment, physician type, GPP illness words, and flare terms and features. The primary outcomes were flare events defined by the frequency with which they occurred per patient, the care context in which they were detected, the kind of specialist treating the incident, related symptoms, and the type of therapy administered before, during, and after the episode. Patients were separated into groups based on whether or not their EHR reported a flare episode. The groups were compared based on demographic factors, comorbidity load, health care utilization, and therapies.