Treatment patterns and healthcare resource utilization in palmoplantar pustulosis patients in Japan: A claims database study

Abstract

BackgroundPalmoplantar pustulosis (PPP) is a chronic, relapsing, inflammatory autoimmune condition, characterized by sterile pustules on the palms and soles. The treatment patterns of PPP and total health care resource utilization in Japan are not well described. Investigating these areas is needed to understand current PPP management in Japan. ObjectiveTo describe the characteristics, medication treatment and health care resource utilization patterns, and associated costs of PPP patients in Japan. MethodsA retrospective analysis of insurance claims data was conducted using the Japan Medical Data Center database. Adult Patients with at least two claims with a PPP diagnosis from January 1, 2011 to March 30, 2017 and six months of follow-up after the first diagnosis were included. Patient characteristics described include age, gender, and comorbid conditions. Treatment patterns assessed include the types of treatment, sequence of treatment, and rates of discontinuation, switching, persistence and use of concomitant medications. ResultsA total of 5,162 adult patients met all inclusion criteria. Mean (SD) patient age was 49.7 (11.6) years and 43.2% were male. A total of 2441 patients (47.8%) received systemic nonbiologic drugs during the entire follow up period, 2,366 (46.4%) were prescribed topical therapy, 273 (5.4%) were prescribed phototherapy, while 18 (0.4%) of patients with other autoimmune comorbidities were eligible for prescribed biologics. For treatment-naïve patients with mild PPP, topical therapy was most commonly (77.1%) prescribed, whereas in

Treatment patterns, healthcare resource utilization, and costs in patients with moderate‐to‐severe psoriasis treated with systemic therapy in Japan: A retrospective claims database study

“…Infliximab, certolizumab pegol, risankizumab, tildrakizumab, ixekizumab, and methotrexate were not evaluated owing to a small sample size (<20 patients each). Treatment discontinuation was defined as having no prescription of the index systemic treatment for at least 60 days following the period covered by the last prescription 22,24,27,28 . The time to treatment discontinuation was defined as the time from the index date to the date of treatment discontinuation, i.e., the last day of the period covered by the last prescription.…”

“…Treatment discontinuation was defined as having no prescription of the index systemic treatment for at least 60 days following the period covered by the last prescription. 22 , 24 , 27 , 28 The time to treatment discontinuation was defined as the time from the index date to the date of treatment discontinuation, i.e., the last day of the period covered by the last prescription. The systemic treatments of interest and their treatment intervals are listed in Table S1 .…”

“… 19 , 20 However, the HCRU information for PsO in the Japanese population is scarce. Studies have assessed healthcare resource utilization for specific forms of PsO, such as generalized pustular PsO (GPP) 21 and palmoplantar pustular PsO; 22 however, few studies have investigated HCRU in PsO, with a focus on systemic therapy use. For example, a recent study by Okubo et al compared HCRU between Japanese patients with GPP and plaque PsO and healthy controls, demonstrating greater HCRU, such as outpatient visits and hospitalization duration in patients with GPP and plaque PsO.…”

Practice Patterns of Palmoplantar Pustulosis: Patient Demographics and Treatment Options

“…This finding is similar to a claims database publication from Japan which reported a large proportion of PPP patients continued topical steroids in addition to systemic therapies. 12 In this retrospective study, apremilast, followed by ustekinumab and guselkumab, appeared to provide the most promising results out of the systemic agents used due to the highest adherence rates. Although the few patients remaining on acitretin, alitretinoin and methotrexate had a good response achieving “clear” or “almost clear”, the proportion of patients remaining on these therapies was low and the majority of patients had discontinued therapy due to adverse events or lack of efficacy.…”

A brief guide to pustular psoriasis for primary care providers

“…The estimated prevalence of GPP ranges from 1.76 per million in Europe to 7.46 per million in Japan [13,14]. The estimated prevalence of PPP ranges from 0.01% and 0.05% [15]; although, one large Japanese study reported a national prevalence of 0.12% [12].…”