All-Cause Mortality is Higher in Generalized Pustular Psoriasis (GPP) than Plaque Psoriasis and the General Population: A US-Based Claims Analysis

Abstract

Background

Limited literature exists on the mortality burden of generalized pustular psoriasis (GPP) in the US.

Objective

To compare all-cause mortality among patients with GPP with matched populations of patients with plaque psoriasis (PsO) and the general population in the US.

Methods

An observational study was conducted using US claims data collected between January 1, 2016 and December 31, 2019. All-cause mortality was evaluated at 365 days post-index and at maximum follow-up in the following cohorts: GPP-only, Plaque-PsO-only, GPP + PsO, All-GPP, and general population. Propensity score matching was used to balance covariates between cohorts. The index date was the first medical claim for GPP (ICD-10 code L40.1) or PsO (L40.0), and a randomly selected date per year for individuals in the general population cohort.

Results

1246 patients were included in GPP-only, 1384 in GPP + PsO, 2630 in All-GPP and 127,540 in plaque-PsO-only. 19,641,441 individuals were included in general population. The maximum follow-up ranged from 36.14 to 41.28 months (3.01-3.44 years). At 365-day follow-up, mortality risk was significantly higher in the All-GPP vs the general population (hazard ratio [HR] 4.93, 95% confidence interval [CI] 2.24-10.88) and plaque-PsO-only (HR 2.31, 95% CI 1.32-4.04) cohorts. At maximum follow-up, the mortality risk for the All-GPP cohort was four times higher than the general population (HR 3.98, 95% CI 2.92-5.43) and 1.5 times higher than the plaque-PsO-only (HR 1.49, 95% CI 1.20-1.85) cohorts.

Conclusion

Patients with GPP exhibited an elevated mortality risk in comparison to the matched plaque-PsO and general population cohorts.