LAUSR

BACKGROUND Because generalized pustular psoriasis (GPP) is uncommon, there are few studies reporting treatments and outcomes for large numbers of patients. OBJECTIVE To report treatments and outcomes in a large cohort of hospitalized patients with GPP. METHODS Using a Japanese national inpatient database, we identified 1516 patients with GPP who required hospitalization from July 2010 to March 2019. We categorized patients into three medication groups: biologics (n = 294), oral agents without biologics (n = 948), or systemic corticosteroids only (n = 274). We investigated their characteristics, treatments, and outcomes. RESULTS Mean age was 66 years (interquartile range: 52-77 years); 50 patients (3.3%) were admitted to the intensive care unit, 125 (8.2%) required blood pressure support, and 63 (4.2%) died. Patients receiving biologics were younger and had fewer comorbidities and lower in-hospital 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%, p = .02). Among those who received biologics, IL-17 inhibitor use increased over time and showed comparable in-hospital mortality and morbidity to that of TNF inhibitors. LIMITATIONS Retrospective study design. Some patients received multiple medications. CONCLUSION Biologic treatments showed favorable outcomes compared with other treatments.