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Clustering the Clinical Course of Chronic Urticaria Using a Longitudinal Database: Effects on Urticaria Remission

PURPOSE: Little is known about the clinical course of chronic urticaria (CU) and predictors of its prognosis. We evaluated CU patient clusters based on medication scores during the initial 3 months of treatment in an attempt to investigate time to remission and relapse rates for CU and to identify p...

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Autores principales: Ye, Young-Min, Yoon, Jiwon, Woo, Seong-Dae, Jang, Jae-Hyuk, Lee, Youngsoo, Lee, Hyun-Young, Shin, Yoo Seob, Nahm, Dong-Ho, Park, Hae-Sim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Academy of Asthma, Allergy and Clinical Immunology; The Korean Academy of Pediatric Allergy and Respiratory Disease 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7984955/
https://www.ncbi.nlm.nih.gov/pubmed/33733635
http://dx.doi.org/10.4168/aair.2021.13.3.390
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author Ye, Young-Min
Yoon, Jiwon
Woo, Seong-Dae
Jang, Jae-Hyuk
Lee, Youngsoo
Lee, Hyun-Young
Shin, Yoo Seob
Nahm, Dong-Ho
Park, Hae-Sim
author_facet Ye, Young-Min
Yoon, Jiwon
Woo, Seong-Dae
Jang, Jae-Hyuk
Lee, Youngsoo
Lee, Hyun-Young
Shin, Yoo Seob
Nahm, Dong-Ho
Park, Hae-Sim
author_sort Ye, Young-Min
collection PubMed
description PURPOSE: Little is known about the clinical course of chronic urticaria (CU) and predictors of its prognosis. We evaluated CU patient clusters based on medication scores during the initial 3 months of treatment in an attempt to investigate time to remission and relapse rates for CU and to identify predictors for CU remission. METHODS: In total, 4,552 patients (57.9% female; mean age of 38.6 years) with CU were included in this retrospective cohort study. The K-medoids algorithm was used for clustering CU patients. Kaplan-Meier survival analysis with Cox regression was applied to identify predictors of CU remission. RESULTS: Four distinct clusters were identified: patients with consistently low disease activity (cluster 1, n = 1,786), with medium-to-low disease activity (cluster 2, n = 1,031), with consistently medium disease activity (cluster 3, n = 1,332), or with consistently high disease activity (cluster 4, n = 403). Mean age, treatment duration, peripheral neutrophil counts, total immunoglobulin E, and complements levels were significantly higher for cluster 4 than the other 3 clusters. Median times to remission were also different among the 4 clusters (2.1 vs. 3.3 vs. 6.4 vs. 9.4 years, respectively, P < 0.001). Sensitization to house dust mites (HDMs; at least class 3) and female sex were identified as significant predictors of CU remission. Around 20% of patients who achieved CU remission experienced relapse. CONCLUSIONS: In this study, we identified 4 CU patient clusters by analyzing medication scores during the first 3 months of treatment and found that sensitization to HDMs and female sex can affect CU prognosis. The use of immunomodulators was implicated in the risk for CU relapse.
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spelling pubmed-79849552021-05-01 Clustering the Clinical Course of Chronic Urticaria Using a Longitudinal Database: Effects on Urticaria Remission Ye, Young-Min Yoon, Jiwon Woo, Seong-Dae Jang, Jae-Hyuk Lee, Youngsoo Lee, Hyun-Young Shin, Yoo Seob Nahm, Dong-Ho Park, Hae-Sim Allergy Asthma Immunol Res Original Article PURPOSE: Little is known about the clinical course of chronic urticaria (CU) and predictors of its prognosis. We evaluated CU patient clusters based on medication scores during the initial 3 months of treatment in an attempt to investigate time to remission and relapse rates for CU and to identify predictors for CU remission. METHODS: In total, 4,552 patients (57.9% female; mean age of 38.6 years) with CU were included in this retrospective cohort study. The K-medoids algorithm was used for clustering CU patients. Kaplan-Meier survival analysis with Cox regression was applied to identify predictors of CU remission. RESULTS: Four distinct clusters were identified: patients with consistently low disease activity (cluster 1, n = 1,786), with medium-to-low disease activity (cluster 2, n = 1,031), with consistently medium disease activity (cluster 3, n = 1,332), or with consistently high disease activity (cluster 4, n = 403). Mean age, treatment duration, peripheral neutrophil counts, total immunoglobulin E, and complements levels were significantly higher for cluster 4 than the other 3 clusters. Median times to remission were also different among the 4 clusters (2.1 vs. 3.3 vs. 6.4 vs. 9.4 years, respectively, P < 0.001). Sensitization to house dust mites (HDMs; at least class 3) and female sex were identified as significant predictors of CU remission. Around 20% of patients who achieved CU remission experienced relapse. CONCLUSIONS: In this study, we identified 4 CU patient clusters by analyzing medication scores during the first 3 months of treatment and found that sensitization to HDMs and female sex can affect CU prognosis. The use of immunomodulators was implicated in the risk for CU relapse. The Korean Academy of Asthma, Allergy and Clinical Immunology; The Korean Academy of Pediatric Allergy and Respiratory Disease 2021-01-12 /pmc/articles/PMC7984955/ /pubmed/33733635 http://dx.doi.org/10.4168/aair.2021.13.3.390 Text en Copyright © 2021 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Ye, Young-Min
Yoon, Jiwon
Woo, Seong-Dae
Jang, Jae-Hyuk
Lee, Youngsoo
Lee, Hyun-Young
Shin, Yoo Seob
Nahm, Dong-Ho
Park, Hae-Sim
Clustering the Clinical Course of Chronic Urticaria Using a Longitudinal Database: Effects on Urticaria Remission
title Clustering the Clinical Course of Chronic Urticaria Using a Longitudinal Database: Effects on Urticaria Remission
title_full Clustering the Clinical Course of Chronic Urticaria Using a Longitudinal Database: Effects on Urticaria Remission
title_fullStr Clustering the Clinical Course of Chronic Urticaria Using a Longitudinal Database: Effects on Urticaria Remission
title_full_unstemmed Clustering the Clinical Course of Chronic Urticaria Using a Longitudinal Database: Effects on Urticaria Remission
title_short Clustering the Clinical Course of Chronic Urticaria Using a Longitudinal Database: Effects on Urticaria Remission
title_sort clustering the clinical course of chronic urticaria using a longitudinal database: effects on urticaria remission
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7984955/
https://www.ncbi.nlm.nih.gov/pubmed/33733635
http://dx.doi.org/10.4168/aair.2021.13.3.390
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