P121 Distribution and treatment patterns in pustular psoriasis on two continents: insights from the international registry (IRASPEN)

Abstract Background Pustular psoriasis is a group or rare, neutrophilic conditions including Generalized Pustular Psoriasis (GPP), Palmoplantar Pustulosis (PPP), and Acrodermatitis Continua of Hallopeau (ACH). Each presents unique management challenges. The International Registry of Pustular Psoriasis (IRASPEN) is a prospective 10-year registry that collects a comprehensive real-world dataset to explore patient demographics, clinical features and treatment patterns all over the world. Methods In 9 centres in Europe and Asia, 81 patients were included with diagnoses established according to the ERASPEN criteria. An analysis was conducted on data categorized by diagnosis, age, gender, and location. The study focuses on the distribution of treatments for GPP, PPP, and ACH across Europe and Asia, detailing how these conditions are managed in different regions. Results In this first analysis, baseline cross-sectional data are presented. 46 patients with PPP were included, making up 56% of the cohort. Thirty patients had GPP, and only five patients had ACH. Demographic Distribution The age range spans from 13 to 86 years. There is a female predominance, with 71% (58) of the cohort being female, which may suggest gender-related differences in disease incidence or reporting. Reflecting the number of centres, the majority of patients are from Europe, with 70 individuals from Germany, Italy, Portugal, Switzerland, and Turkey. The Asian cohort includes 11 patients from Singapore and Malaysia. Treatment strategies Of all treatment choices used in PPP, 46% were topical, 37% classic systemic drugs and 17% biological drugs. In GPP, 22% of treatments chosen were topical, 43% classic systemic drugs and 35% biologics. Insight into real-world treatment efficacy was as yet limited as the registry had just started. Conclusion The IRASPEN registry elucidates significant geographical and demographic distinctions in the management of pustular psoriasis. The varied treatment approaches, particularly the heavy reliance on topical agents for PPP and more aggressive treatments for GPP, underscore the necessity for personalized therapeutic strategies. These findings advocate for tailored treatment plans that consider both the type of psoriasis and regional health care practices to optimize patient outcomes.