Clinical course and outcomes of pemphigus vulgaris and foliaceus: A retrospective study using a nationwide database in Japan
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- Hideaki Miyachi
- Department of Dermatology, Graduate School of Medicine Chiba University Chiba Japan
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- Takaaki Konishi
- Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo Tokyo Japan
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- Yohei Hashimoto
- Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo Tokyo Japan
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- Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo Tokyo Japan
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- Kiyohide Fushimi
- Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
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- Takashi Inozume
- Department of Dermatology, Graduate School of Medicine Chiba University Chiba Japan
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- Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo Tokyo Japan
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説明
<jats:title>Abstract</jats:title><jats:p>Pemphigus is a life‐threatening autoimmune blistering disease. Patient characteristics, treatment courses, and outcomes remain unclear owing to its rarity. To describe the background, treatment, and outcomes of pemphigus, we identified 2598 patients with pemphigus vulgaris and 1186 patients with pemphigus foliaceus from a nationwide inpatient database in Japan. Patients with pemphigus vulgaris were younger (62 vs 72 years, <jats:italic>P</jats:italic> < 0.001), had fewer comorbidities, and were more likely to be admitted to high‐volume hospitals (38% vs 30%, <jats:italic>P</jats:italic> < 0.001) than those with pemphigus foliaceus. Patients with pemphigus vulgaris had undergone more aggressive treatment, including steroid pulse therapy, intravenous immunoglobulin, or plasmapheresis, compared with those with pemphigus foliaceus (48% vs 42%, <jats:italic>P</jats:italic> = 0.001); specifically, in patients aged <70 years, the pemphigus vulgaris group was more likely to undergo aggressive treatment than the pemphigus foliaceus group (52% vs 45%), whereas there was no significant difference in patients aged ≥70 years (40% vs 40%). Immunosuppressive agents (30% vs 26%, <jats:italic>P</jats:italic> = 0.015) and analgesics, including opioids (45% vs 36%, <jats:italic>P</jats:italic> < 0.001), were used more frequently, whereas topical corticosteroids were used less frequently (32% vs 48%, <jats:italic>P</jats:italic> < 0.001) in patients with pemphigus vulgaris compared with those with pemphigus foliaceus. In‐hospital mortality was lower in patients with pemphigus vulgaris than in those with pemphigus foliaceus (2.2% vs 4.0%, <jats:italic>P</jats:italic> = 0.002); in the comparison stratified by age, the mortality was equivalent among the two groups (0.6% in patients aged <70 years and 6.1% in those aged ≥70 years). Overall, patients with pemphigus vulgaris had a 10‐day longer hospitalization period and higher hospitalization costs than those with pemphigus foliaceus. Our findings provide useful information for understanding the current trends in the management of pemphigus in Japan.</jats:p>
収録刊行物
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- The Journal of Dermatology
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The Journal of Dermatology 50 (2), 212-221, 2022-11-24
Wiley
