Epidemiological survey from 2009 to 2012 of psoriatic patients in Japanese Society for Psoriasis Research

Abstract

Since 1982, the Japanese Society for Psoriasis Research has conducted annual epidemiological surveys of patients with psoriasis. Kawada et al. have reported data for 1982-2001 and Takahashi et al. have reported data for 2002-2008. The present study evaluated 9290 psoriatic cases according to age and sex (2009-2012). The male : female ratio was 2.08:1 (6281 male patients [67.6%] to 3009 female patients [32.4%]). The most prevalent type was psoriasis vulgaris (85.6% of all cases), which was followed by psoriasis arthropathica (6.0%), psoriasis guttate acuta (3.2%), Zumbusch-type generalized pustular psoriasis (1.8%) and psoriasis erythroderma (1.5%). Psoriasis vulgaris was the most prevalent type for all ages, while psoriasis arthropathica and psoriasis guttate acuta were most prevalent among patients aged less than 65 years. The present survey detected an increased number of cases with comorbid diabetes and/or arthritis symptoms compared with the previous surveys. We found that treatments frequently involved topical corticosteroids (89.7% of cases) and vitamin D ointments (78.0% of cases), with a notable increase in the use of vitamin D ointments. Systemic treatments were used in 33.3% of cases, including cyclosporin (33.6%), etretinate (19.5%), methotrexate (8.6%), infliximab (11.4%), adalimumab (10.9%) and ustekinumab (6.2%). Phototherapy was used in 30.9% of cases. Although psoralen plus ultraviolet A therapy was the predominant phototherapy during previous studies, the present survey revealed that narrowband ultraviolet B therapy was used in 84.5% of phototherapy-treated cases. Thus, the present survey revealed major changes in treatment trends.

Adalimumab treatment in Japanese patients with generalized pustular psoriasis: Results of an open‐label phase 3 study

“…In recent years, biologic agents (most commonly the TNF‐α inhibitors infliximab and adalimumab and the IL‐12 and ‐23 inhibitor ustekinumab) have been used more to treat psoriasis in Japan . Other than the present clinical trial, only one other study has prospectively examined a biologic agent (the IL‐17 inhibitor secukinumab) solely for the treatment of Japanese patients with GPP ( n = 12) .…”

“…Generalized pustular psoriasis (GPP) is the most severe type of psoriasis, characterized by pyrexia, skin redness over the entire body, and multiple sterile pustules occasionally leading to fatal systemic symptoms . Among Japanese patients with psoriasis, only 2.3% were affected by GPP between 2009 and 2012 . Systemic treatments for GPP recommended by Japanese guidelines are limited to etretinate, cyclosporin, methotrexate and tumor necrosis factor‐α (TNF‐α) inhibitors .…”

“…1 Among Japanese patients with psoriasis, only 2.3% were affected by GPP between 2009 and 2012. 2 Systemic treatments for GPP recommended by Japanese guidelines are limited to etretinate, cyclosporin, methotrexate and tumor necrosis factor-a (TNF-a) inhibitors. 3 Recently, the interleukin (IL)-17 inhibitors brodalumab, ixekizumab and secukinumab were approved to treat GPP in Japan.…”

The CCL20 and CCR6 axis in psoriasis

“…Psoriasis has shown a diverse prevalence across populations worldwide: 2.5% in Europeans, 0.05%‐3% in Africans and 0.1%‐0.5% in Asians . Males are twice as likely as females to be affected . As desquamative erythema can affect any site of skin, psoriasis profoundly impairs the patients' quality of life, treatment satisfaction and adherence, and socioeconomic stability .…”

Long‐term efficacy and safety of ixekizumab in Japanese patients with erythrodermic or generalized pustular psoriasis: subgroup analyses of an open‐label, phase 3 study (UNCOVER‐J)

“…Plaque psoriasis is a relatively common, immune‐mediated skin condition that affects 0.3% of the Japanese population . Erythrodermic and generalized pustular psoriasis are relatively rare forms of psoriasis (1.5% and 1.8% prevalence, respectively, of all psoriasis in Japan) that can be more severe and challenging to treat. Further, relapses are common with these forms of psoriasis and systemic treatment is often necessary.…”