Supplementary Material for: Demographics, Comorbidity, Treatment, Healthcare Resource Utilization and Costs Analysis of Hidradenitis Suppurativa in Dubai

Introduction: Hidradenitis suppurativa (HS) is a chronic, inflammatory, and debilitating skin disorder with a substantial disease burden. Currently, there is a dearth of information regarding healthcare resource utilization (HCRU) and treatment patterns for patients with HS in Dubai. A better understanding of disease demographics and patient characteristics are necessary for reducing the healthcare costs. The current study evaluated the disease burden, treatment patterns, HCRU, and associated costs in patients with hidradenitis suppurativa, in Dubai, United Arab Emirates (UAE).
Methods: This secondary, longitudinal, retrospective, single-cohort study was conducted from 01 January 2014 to 31 December 2021. Dubai Real-World Claims Database (DRWD) was used for patients’ information. Study included patients with first diagnosis claim during the index period and had continuous enrolment. Patients who did not have continuous enrolment were excluded from the study. Study population was identified based on International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code L73.2. Patients’ demographics, common comorbidities, treatment patterns, specialty analysis, HCRU, and in patient length of stay were investigated.
Results: The study included 13,180 patients (median age: 37 years), with similar gender distribution (male: 50.4%; female: 49.6%). The overall reported cases of HS (2015-2021) was in the range of 1,350 to 3,719. Type 2 diabetes mellitus was the most common comorbidity (59.0%). Topical and systemic antibiotics were most frequently prescribed medications (79.6%), followed by systemic and topical anti-acne medications (27.7%), and non-steroidal anti-inflammatory drugs (27.2%). Overall HCRU and associated costs increased by 76.9% from 12-month pre-index period to 12-month post-index period. Disease-specific median healthcare costs contributed largely (79.5%) to the overall healthcare costs. In the post-index period, contribution of disease-specific median healthcare costs to all-cause median healthcare costs was highest for diagnosis related group (DRG) (97.9%), followed by consumables (88.4%), procedures (37.5%), services (27.6), and medications (25.4%).
Conclusion: HS is well-documented disease in Dubai claims data and is associated with significant morbidity and healthcare costs. This sheds light on the high burden of HS and should trigger increased awareness as well as new disease management interventions. Newer therapies such as biologics should play a role in the management of HS in the UAE.

引言：化脓性汗腺炎（Hidradenitis suppurativa, HS）是一种慢性炎症性致残性皮肤病，疾病负担沉重。目前，针对迪拜化脓性汗腺炎患者的医疗资源利用（healthcare resource utilization, HCRU）与治疗模式相关信息仍较为匮乏。深入了解该疾病的人口统计学特征与患者特征，是降低医疗成本的必要前提。本研究针对阿拉伯联合酋长国（阿联酋）迪拜的化脓性汗腺炎患者，评估了其疾病负担、治疗模式、医疗资源利用及相关医疗成本。
方法：本研究为二级纵向回顾性单队列研究，研究时段为2014年1月1日至2021年12月31日，采用迪拜真实世界索赔数据库（Dubai Real-World Claims Database, DRWD）获取患者信息。研究纳入索引期内首次提交诊断索赔且持续参保的患者，排除未持续参保的患者。研究队列基于国际疾病分类第十次修订版临床修订版（International Classification of Diseases, Tenth Revision, Clinical Modification, ICD-10-CM）代码L73.2进行识别。本研究分析了患者人口统计学特征、常见合并症、治疗模式、专科分析、医疗资源利用及住院时长。
结果：本研究共纳入13180例患者（中位年龄37岁），性别分布均衡（男性占50.4%，女性占49.6%）。2015年至2021年的整体报告病例数介于1350例至3719例之间。2型糖尿病是最常见的合并症（占比59.0%）。外用及系统性抗生素是最常开具的药物（占比79.6%），其次为系统性及外用抗痤疮药物（占比27.7%）与非甾体类抗炎药（占比27.2%）。从索引前12个月至索引后12个月，整体医疗资源利用及相关成本增长76.9%。疾病特异性中位医疗成本占整体医疗成本的绝大部分（79.5%）。在索引后阶段，疾病特异性中位医疗成本占全因中位医疗成本的占比以诊断相关组（diagnosis related group, DRG）最高（97.9%），其次为耗材（88.4%）、操作（37.5%）、服务（27.6%）及药物（25.4%）。
结论：化脓性汗腺炎在迪拜索赔数据库中已有充分记录，且与显著的发病率及医疗成本相关。本研究结果凸显了化脓性汗腺炎的沉重疾病负担，应推动提升公众认知并开发全新的疾病管理干预手段。生物制剂等新型疗法应在阿联酋的化脓性汗腺炎治疗中发挥作用。