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Clinical phenotypes of sarcoidosis using cluster analysis: a Spanish population-based cohort study.

Authors :
Fernández-Ramón R
Gaitán-Valdizán JJ
Martín-Varillas JL
Demetrio-Pablo R
Ferraz-Amaro I
Castañeda S
Blanco R
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.

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