OBJECTIVES: The objectives of this research were to describe underlying demographic, clinical, and disease activity characteristics of generalized pustular psoriasis (GPP) patients by flare status and to characterize the timing and frequency of GPP flares.

METHODS: US Outpatient electronic health record data (2017-2023) from 5 specialty dermatology networks in the OMNY Health platform were accessed. Patients with accessible clinical notes were indexed at their first GPP diagnosis code. GPP flares were identified based on an algorithm derived from natural language processing of clinical notes. Flare duration was assumed to be 6 weeks. Patient demographic, clinical, and disease activity characteristics at index diagnosis were summarized, and GPP flare characteristics were described.

RESULTS: Of the 638 GPP patients identified, 234 (37%), 298 (47%), and 106 (17%) experienced 0, 1, and 2 or more flares, respectively. Mean (median) number of flares per patient per year was 0.91 (0.51) among patients with ≥ 90 days of follow-up data. Among those with flares, the GPP flares per patient per year was 1.40. Patients who flared (vs. did not flare) were more likely to be female (76% vs. 71%), non-white (15% vs. 8%), and Hispanic/Latino (10% vs. 2%). Distributions of age, geographic region, and medical history were similar between patients who did and did not flare. At index diagnosis, patients who flared exhibited greater levels of disease activity as measured by mean (median) body surface area [13 (6) vs. 7 (4)], moderate or severe physician global assessment rating (64% vs. 54%), and 10-point pain visual analogue scale score ≥ 3 (32% vs. 22%).

CONCLUSIONS: Notable differences in index GPP patient demographic and clinical characteristics were observed between patients that did and did not flare. Greater baseline disease activity was observed for patients who flared. Results provide insights into clinical characteristics associated with GPP flare in the real-world setting.