Hospitalization in Patients with Psoriasis: Impact of Biological Therapies on Temporal Evolution

February 2021 | Volume 20 | Issue 2 | Original Article | 208 | Copyright © February 2021


Published online January 11, 2021

Queila Rodriguez-Jato MDa, Alessia Ruibal Pereira a, Ana Batalla MD PhDa, Maria Teresa Abalde MDa, Laura Salgado-Boquete MDa, Crisitina Martinez-Reglero b, Virginia Fernández-Redondo MD PhDa, Angeles Florez MD PhDa

aComplejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
bInstituto de Investigación Sanitaria Galicia Sur (IISGS), Alvaro Cunqueiro Hospital,Vigo, Pontevedra, Spain

Abstract
Background: Psoriasis is an immunomediated disease mostly controlled at the outpatient level, although there is a low percentage of patients that require systemic drugs or even hospitalization for an adequate control. Biological drugs have represented a turning point in its treatment. So far, despite the growing interest in psoriasis and its management with biological therapies, there is a lack of studies focusing on their impact on hospitalization, a relevant issue to patients and to the sustainability of our healthcare system.
Objective: In this study, we aimed to describe the temporal evolution of the hospitalizations of patients with psoriasis throughout the period between eight years before the commercialization of the first biological drugs and present, and secondly, whether this market irruption was related to a decrease in the number of admissions.
Methods: Data was collected retrospectively from the Dermatology department of the Complexo Hospitalario Universitario de Ponte- vedra (CHUP) including patients of all ages with a diagnosis of psoriasis and at least one admission to the department of Dermatology along the study period. We established different time periods for comparing the average hospitalizations per 100,000 inhabitants-year and the average stay, considering that the first biologic drug marketed for the treatment of psoriasis was in 2004.
Results: Regression models indicated a significant change in the temporal trend of the hospitalization rate per 100,000 inhabitants-year starting in 2004. In all cases, a gradual and significant decrease in the number of admissions per 100,000 inhabitants-year and in the average hospitalization rate per psoriasis per 100,000 inhabitants-year along the study period were found. There was also a significant decrease in medical hospitalizations and medical hospitalizations excluding psoriasis throughout the study period.
Conclusions: In our study population hospitalizations for psoriasis descended progressively and significantly from 2004. So far there are no extensive data on the impact of biological therapies on psoriasis hospitalization.

J Drugs Dermatol. 2021;20(2):208-214. doi:10.36849/JDD.2021.4931

INTRODUCTION

Psoriasis is a chronic inflammatory disease which affects approximately 0.09-5.1% of the population worldwide.1 The majority of patients manage the disease with topical treatment. However, there is a lower percentage of more severe cases that require classic or biological systemic drugs, and also a smallest subgroup with particularly refractory disease, requiring hospitalization for an adequate control.1,2 Biological drugs have supposed a turning point in the treatment of psoriasis, as even in those patients with severe, refractory or generalized disease, they can achieve improvements of 75% or 90% with respect to the basal state.3-8 Thus, it seems logical to think that, parallel to the commercialization and availability of these biological drugs, a decrease in the number of hospitalizations due to psoriasis flare-ups would occur. So far, few studies have evaluated this issue.

OBJECTIVES

The main objective was to describe the temporal evolution of the hospitalizations of patients with psoriasis throughout the period between eight years before the commercialization of the first biological drugs, and present. Secondly, we tried to determine whether the market irruption of biological drugs was related to a decrease in the number of admissions.

METHODS

This is a cross-sectional descriptive study carried out in the Dermatology department of the Complexo Hospitalario Universitario de Pontevedra (CHUP), which has a stable reference population of approximately 300.000 inhabitants. We included patients of all ages with a diagnosis of psoriasis who had been admitted to the Dermatology department due to psoriasis, in the period between January 1996 and December