Generalized Pustular Psoriasis (GPP)

Patients with generalized pustular psoriasis (GPP) have increased comorbidity compared with the general population and with patients with psoriasis vulgaris (PV), according to a study published online Oct. 11 in the
 
 Journal of the American Academy of Dermatology
 
 .




 Sofia Löfvendahl, Ph.D., from the Swedish Institute for Health Economics in Lund, Sweden, and colleagues examined the comorbidity profile of GPP compared to the general population and patients with PV using the Swedish National Patient Register. A total of 1,093 GPP cases were identified during 2004 to 2015 and were matched in a 1:3 ratio with PV controls without GPP and in a 1:5 ratio with general population controls. Fifty-three percent of the GPP cases also had PV. A subgroup analysis was conducted including 514 GPP cases without PV and 1,518 corresponding PV controls.




 The researchers found that 70 percent of the GPP cases had any of the selected comorbidities compared with 46 and 63 percent of general population controls and PV controls, respectively. Hypertension, psoriatic arthritis, type 2 diabetes, and hyperlipidemia were the most prevalent conditions in GPP. Compared with both the general population controls and PV controls, GPP cases had significantly higher odds ratios for any of the selected comorbidities. The largest significant differences between GPP cases and general population controls were for allergic contact dermatitis, Crohn disease, non-alcoholic fatty liver disease, nephritic nonhypertensive disease, and obesity. Comparing GPP cases with PV controls, the largest significant differences were seen for hypertensive disease, Crohn disease, chronic renal failure, type 1 and 2 diabetes, peptic ulcer disease, and psoriasis arthritis.




 "The study indicates a higher comorbidity burden in GPP in Sweden compared to both the general population and PV," the authors write.




 The research was funded by AbbVie, Boehringer Ingelheim, Eli Lilly, Janssen Cilag, Leo Pharma, and Novartis.




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Most prevalent conditions in GPP were hypertension, psoriatic arthritis, type 2 diabetes, hyperlipidemia

Comorbidity Burden Higher in Generalized Pustular Psoriasis

The U.S. Food and Drug Administration has approved SPEVIGO (spesolimab-sbzo) as the first treatment option for generalized pustular psoriasis (GPP) flares in adults.




 SPEVIGO is a novel, selective antibody infusion that blocks the activation of the interleukin-36 receptor, which is part of an immune system signaling pathway thought to be involved in the cause of GPP. The approval was based on a 12-week trial in which 53 patients with a GPP flare were treated with SPEVIGO or placebo. After one week, more patients treated with SPEVIGO showed no visible pustules than those treated with placebo (54 versus 6 percent).




 The most common adverse reactions (≥5 percent) reported in patients taking SPEVIGO were asthenia and fatigue, nausea and vomiting, headache, pruritus and prurigo, infusion site hematoma and bruising, and urinary tract infection.




 "GPP flares can greatly impact a patient's life and lead to serious, life-threatening complications," Mark Lebwohl, M.D., lead investigator for the trial, said in a statement. "The approval of SPEVIGO is a turning point for dermatologists and clinicians."




 Approval of SPEVIGO was granted to Boehringer Ingelheim.




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The monoclonal antibody infusion is approved for use in adults

FDA Approves SPEVIGO for Generalized Pustular Psoriasis Flares

There is unmet need for the treatment of generalized pustular psoriasis (GPP) flares, according to a study published online Aug. 10 in
 
 JAMA Dermatology
 
 .




 Carla L. Zema, Ph.D., from Boehringer Ingelheim Pharmaceuticals in Ridgefield, Connecticut, and colleagues used electronic health records from 1,535 patients with GPP to assess flares and treatment.




 The researchers found that compared with patients without flares, patients with flares had a 34 percent higher mean Charlson Comorbidity Index score, were almost three times more likely to have inpatient visits, were more than twice as likely to have emergency department visits, and had higher use of almost all treatment classes. Flares were observed across treatment settings (outpatient, 53 percent; inpatient, 36 percent; emergency department, 9 percent). Topical corticosteroids (35 percent), opioids (21 percent), other oral treatments (e.g., methotrexate, cyclosporine, tacrolimus; 13 percent), and oral corticosteroids (11 percent) were the most common treatments for flares. For almost one-quarter of flare episodes (24 percent), patients had no dermatologic treatment 30 days before, during, or 30 days after the episode.




 "This cohort study suggests that there is significant unmet need for the treatment of GPP and its flares, as evidenced by patients seeking treatment in inpatient and emergency department settings, as well as the lack of advanced treatments," the authors write.




 Several authors disclosed financial ties to the pharmaceutical industry.




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Patients with flares more likely to have inpatient, emergency department visits

Generalized Pustular Psoriasis (GPP) Condition Center

Generalized Pustular Psoriasis (GPP) News & Research