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Clinical phenotypes of sarcoidosis using cluster analysis: a Spanish population-based cohort study.
- Source :
-
Clinical and experimental rheumatology [Clin Exp Rheumatol] 2024 Nov; Vol. 42 (11), pp. 2150-2158. Date of Electronic Publication: 2024 Sep 09. - Publication Year :
- 2024
-
Abstract
- Objectives: Sarcoidosis is a clinically heterogenous disease. The objective of this study is the identification of clinical phenotypes using cluster analysis.<br />Methods: A model-based clustering relaying on 19 clinical variables was performed in a retrospective cohort of 342 sarcoidosis patients, diagnosed and followed-up from 1999 to 2019 in a tertiary hospital at Northern Spain. Chi-square test and ANOVA were used to compare categorical and continuous variables among groups. Two-sample t-tests and the partition of Pearson's chi-square statistic were used in pairwise comparisons. The Wasfi severity score was calculated and compared among clusters.<br />Results: Cluster analysis identified five groups: C1 (16.1%), C2 (14.3%), C3 (24.3%), C4 (5.0%), and C5 (40.4%). Lung involvement was predominant, ranging from 55.1% (C2) to 100% (C1 and C4). Extrapulmonary involvement was significantly higher in C2 (96.4%) and C3 (98.0%). A significant lower FEV1 percent predicted was detected in C5 (90.5±21.8) versus C1 (102.0±22.9), C3 (102.3±17.6) and C4 (105.8±20.8). The cluster 5 had a lower FVC percent predicted (96.6±18.9) than others, ranging from 108.1±18.0 (C3) to 111.5±21.7 (C4). The prescription of systemic glucocorticoids and non-corticosteroid immunosuppressants was higher in the clusters 1, 3 and 5. Chronicity rates were higher in C3 (31.3%) and C5 (32.6%) compared to C1 (9.1%) and C4 (0%), as well as the Wasfi severity score values.<br />Conclusions: Five phenotypes with different clinical and prognostic characteristics are proposed in our study. Cluster analysis can be a useful tool for identifying clinical patterns in a disease as heterogeneous as sarcoidosis and optimising its management.
- Subjects :
- Humans
Female
Male
Spain epidemiology
Middle Aged
Cluster Analysis
Adult
Retrospective Studies
Severity of Illness Index
Sarcoidosis, Pulmonary diagnosis
Sarcoidosis, Pulmonary drug therapy
Sarcoidosis, Pulmonary physiopathology
Sarcoidosis, Pulmonary epidemiology
Vital Capacity
Aged
Forced Expiratory Volume
Phenotype
Sarcoidosis epidemiology
Sarcoidosis diagnosis
Sarcoidosis drug therapy
Sarcoidosis physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 0392-856X
- Volume :
- 42
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Clinical and experimental rheumatology
- Publication Type :
- Academic Journal
- Accession number :
- 39263805
- Full Text :
- https://doi.org/10.55563/clinexprheumatol/q2idtc