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


1, 2, 3, 4, 5, 6, 7

 

  1. Department of Ophthalmology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
  2. Department of Ophthalmology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
  3. Department of Rheumatology, Hospital de Laredo, Cantabria, Spain.
  4. Department of Ophthalmology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
  5. Department of Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain.
  6. Department of Rheumatology, Hospital Universitario de La Princesa, Madrid; Cátedra UAM-Roche, EPID-Future, Universidad Autónoma de Madrid (UAM), Madrid, Spain.
  7. Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, Santander, and Immunopathology Group, Marqués de Valdecilla University Hospital-IDIVAL, Santander, Spain. rblancovela@gmail.com

CER17459
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PMID: 39263805 [PubMed]

Received: 10/01/2024
Accepted : 08/04/2024
In Press: 09/09/2024

Abstract

OBJECTIVES:
Sarcoidosis is a clinically heterogenous disease. The objective of this study is the identification of clinical phenotypes using cluster analysis.
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.
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.
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.

DOI: https://doi.org/10.55563/clinexprheumatol/q2idtc

Rheumatology Article