The Burden and Management of Flares Among Pregnant Patients With Generalized Pustular Psoriasis (GPP): Real-World Evidence (RWE) From the Global SCRIPTOR Study

Author(s)

Laurent Misery, MD, PhD1, Denis Jullien, MD, PhD2, Manuelle Viguier, MD, PhD3, Richard B. Warren, MBChB, PhD4, Christopher Griffiths, MD4, Latha R. Selvarajah, MBBS, MRCP5, Azura Mohd Affandi, MBChB, MRCP6, Renata Magalhães, MD, PhD7, Anber Tanaka, MD8, Slaheddine Marrakchi, MD, PhD9, Wen-Hung Chung, MD, PhD10, Tsen-Fang Tsai, MD11, Bhargav Lakshminarasimhan, PharmD, MBA12, Nichiren Pillai, MSc, MBA12, Shah Alam Khan, MBBS, MS12, Rafael Sani Simoes, MD12, Mark G. Lebwohl, MD13, Xinghua Gao, MD, PhD14.
11. Department of Dermatology, Venereology and Allergology and French Expert Centre on Pruritus, University Hospital of Brest, Brest, France, 2Department of Dermatology, Faculty of Medicine Lyon-Est, Hôpital Edouard Herriot, University of Lyon, Lyon, France, 3Université de Reims-Champagne Ardenne, Service de Dermatologie, Hôpital Robert Debré, Reims, France, 4Centre for Dermatology Research, Northern Care Alliance NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom, 5Department of Dermatology, Hospital Sultan Ismail, Johor Bahru, Johor, Malaysia, 6Department of Dermatology, Hospital Kuala Lumpur and the Malaysian Ministry of Health, Kuala Lumpur, Malaysia, 7Department of Dermatology, Medical Sciences School, University of Campinas, Sao Paulo, Brazil, 8Dermatology Service, Evangélico Mackenzie University Hospital of Paraná, Paraná, Brazil, 9Department of Dermatology, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia, 10Department of Dermatology, Chang Gung Memorial Hospital, Taipei & Linkou, Taiwan, 11Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan, 12Boehringer Ingelheim International GmbH, Ingelheim, Germany, 13Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA, 14The First Hospital of China Medical University, Heping District, Shenyang, China.
OBJECTIVES: GPP is a serious, chronic, systemic neutrophilic disease with a heterogenous, unpredictable clinical course. GPP flares are potentially triggered or exacerbated by pregnancy, but there are limited data on management during pregnancy. We describe real-world GPP flare management during pregnancy.
METHODS: SCRIPTOR was an international retrospective, observational, non-interventional chart review to describe treatment patterns and clinical burden in patients diagnosed with GPP. Patients diagnosed with GPP after 2011 were eligible for inclusion. The index date was the date of GPP diagnosis and data were extracted from the index date until the last available record. Pregnant patients were identified, and flare and treatment data were extracted from the relevant medical records.
RESULTS: Fifteen pregnant patients were identified from SCRIPTOR. Thirteen of these patients experienced a total of 35 flares (median 2.0 per patient, range 1.0-8.0) during follow up, with 15/35 flares occurring during pregnancy. Half (7/13; 53.8%) of these patients experienced a flare during their third trimester. Nine patients (60.0%) experienced 37 complications due to GPP (mean 4.1 [standard deviation (SD) 3.5]) during follow up, with four (10.8%) reports of sepsis. There were 134 prescriptions for treatments to manage these 35 flares during follow up, with corticosteroid (48/134, 35.8%), cyclosporin (18/134, 13.4%) and methotrexate (8/134, 6.0%; contraindicated for use during pregnancy) the most frequently prescribed. Mean (SD) treatment duration was 94.3 (203.4) days. Reasons for prescription termination included: symptom improvement/resolution/end of treatment (73/134, 54.5%); dose adjustment - increase/decrease/formulation change (32/134, 23.9%); lack of efficacy (13/134, 9.7%); and adverse events (1/134, 0.7%).
CONCLUSIONS: This analysis, based on RWE from SCRIPTOR, suggests GPP flare management during pregnancy comprises off-label corticosteroids and immunosuppressants, with a third of prescriptions terminated for lack of efficacy or for dose adjustments. These data may help inform risk-benefit analyses and treatment decision-making in this population of patients with GPP.

Conference/Value in Health Info

2025-11, ISPOR Europe 2025, Glasgow, Scotland

Value in Health, Volume 28, Issue S2

Code

RWD179

Topic

Real World Data & Information Systems

Disease

Sensory System Disorders (Ear, Eye, Dental, Skin)

Your browser is out-of-date

ISPOR recommends that you update your browser for more security, speed and the best experience on ispor.org. Update my browser now

×