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This analysis highlights the global prevalence of HS and some of the most significant global variations in HS prevalence.
The global prevalence of hidradenitis suppurativa (HS) is between 0.67% - 1.46%, recent findings suggest, surpassing prior global estimates.1
These findings further suggest widespread variance in global HS prevalence variations. Dorra Bouazzi, MD, PhD—from the PHOENIX Center at the Herlev-Gentofte Hospital Department of Allergy in Gentofte, Denmark—worked along with a team of other investigators in authoring this analysis.
Bouazzi and coauthors sought to explore global HS rates and the ways in which rates vary around the world.
“The Global Hidradenitis Suppurativa Atlas (GHiSA) has systematically gathered comparable HS prevalence data through the Global Prevalence Study (GPS),” Bouazzi and colleagues wrote.1 “The objective was to estimate the global HS prevalence across diverse populations and to analyze prevalence variations by age, sex, geographical location, body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), smoking status, gross domestic product (GDP), and Human Development Index (HDI).”
The investigative team sought to explore the worldwide prevalence of HS, looking into the variations observed across the world in prevalence of the skin disease. The team highlighted that this inflammatory skin disease has a significant negative impact on the lives of those with this condition, adding that there had been a general lack of global epidemiological information.
Eligible studies adhered to the standardized Global Hidradenitis Suppurativa Atlas (GHiSA) methodology, with final data collection completed before May 19, 2023.2 Bouazzi et al's criteria for study eligibility required clinical confirmation of HS following an initial screening questionnaire and population-based sampling. Their analysis was based upon a proportional meta-analysis of the GHiSA Global Prevalence Studies (GPS), a set of cross-sectional studies that applied the same methodology.
A pair of reviewers were asked to independently gather the necessary study data via a uniform template. Variables related to HS prevalence included geographic area, BMI (median and proportion with BMI > 30), sex, smoking status, age, prevalence estimates of HS with 95% confidence intervals (CIs), as well as GDP and HDI. A random-effects proportional meta-analysis was then performed on the pooled studies.
The primary endpoint was the point prevalence of clinically confirmed HS. Pre-specified secondary endpoints were subgroup differences in prevalence by sex, age group, BMI status, smoking, and national socioeconomic measures (GDP and HDI).
The investigators' dataset comprised 22,743 trial participants from 25 studies across 23 countries representing 6 continents, among whom 247 HS cases were identified. 55.6% of these subjects were reported as female and the median age of patients with HS was shown to be 34.5 years. While prevalence estimates varied significantly across studies (I² > 75%; τ² = 0.747), the pooled random-effects global prevalence of HS was 0.99% (95% CI, 0.67%–1.46%). Among the variables the team looked into, only female sex was found by the team to be significantly linked to prevalence estimates (β = 1.02; 95% CI, 1.01–1.03).
Bouazzi and coauthors' analysis suggests that the worldwide prevalence of HS likely falls between 0.67% - 1.46%, which was noted as higher than earlier data showed. Marked regional variability was evident, but female sex emerged as the sole factor consistently linked to prevalence in this dataset. The necessity for additional research was expressed by the investigators, with the rationale being clarification of genetic, environmental, and etiological contributors to the observed heterogeneity.
“In this meta-analysis, we estimated the global prevalence of HS to 0.99% (95% CI, 0.67%-1.46%),” they wrote.1 “Proportion of female sex was the only factor that was associated with the prevalence. Substantial global variations in HS prevalence were observed. Further studies are needed to investigate the underlying causes of the substantial global variations in HS prevalence.”
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