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A cluster analysis of patients with axial spondyloarthritis using tumour necrosis factor alpha inhibitors based on clinical characteristics

BACKGROUND: This study aimed to classify the distinct group of patients with axial spondyloarthritis (SpA) on tumour necrosis factor alpha inhibitors (TNFi) according to the baseline characteristics using a clustering algorithm. METHODS: The clinical characteristics and demographic data of patients...

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Autores principales: Lee, Seulkee, Kang, Seonyoung, Eun, Yeonghee, Won, Hong-Hee, Kim, Hyungjin, Cha, Hoon-Suk, Koh, Eun-Mi, Lee, Jaejoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8591959/
https://www.ncbi.nlm.nih.gov/pubmed/34782006
http://dx.doi.org/10.1186/s13075-021-02647-z
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author Lee, Seulkee
Kang, Seonyoung
Eun, Yeonghee
Won, Hong-Hee
Kim, Hyungjin
Cha, Hoon-Suk
Koh, Eun-Mi
Lee, Jaejoon
author_facet Lee, Seulkee
Kang, Seonyoung
Eun, Yeonghee
Won, Hong-Hee
Kim, Hyungjin
Cha, Hoon-Suk
Koh, Eun-Mi
Lee, Jaejoon
author_sort Lee, Seulkee
collection PubMed
description BACKGROUND: This study aimed to classify the distinct group of patients with axial spondyloarthritis (SpA) on tumour necrosis factor alpha inhibitors (TNFi) according to the baseline characteristics using a clustering algorithm. METHODS: The clinical characteristics and demographic data of patients with axial SpA included in the Korean College of Rheumatology Biologics and Targeted Therapy registry were investigated. The patterns of disease manifestations were examined using divisive hierarchical cluster analysis. After clustering, we compared the clinical characteristics of patients and the drug survival of TNFi between the classified groups. RESULTS: A total of 1042 patients were analysed. The cluster analysis classified patients into two groups: axial group predominantly showing isolated axial manifestations (n = 828) and extra-axial group more frequently showing extra-axial symptoms (n = 214). Almost all extra-axial symptoms (peripheral arthritis, enthesitis, uveitis, and psoriasis) were more frequently observed in the extra-axial group than in the axial group. Moreover, patients in the extra-axial group had shorter disease duration, later disease onset, and higher disease activity than those in the axial group. The disease activity was comparable between the two groups after 1 year of treatment with TNFi. Interestingly, the extra-axial group had a lower drug survival with TNFi than the axial group (p = 0.001). CONCLUSIONS: Cluster analysis of patients with axial SpA using TNFi classified two distinct clinical phenotypes. These clusters had different TNFi drug survival, clinical characteristics, and disease activity. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13075-021-02647-z.
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spelling pubmed-85919592021-11-15 A cluster analysis of patients with axial spondyloarthritis using tumour necrosis factor alpha inhibitors based on clinical characteristics Lee, Seulkee Kang, Seonyoung Eun, Yeonghee Won, Hong-Hee Kim, Hyungjin Cha, Hoon-Suk Koh, Eun-Mi Lee, Jaejoon Arthritis Res Ther Research Article BACKGROUND: This study aimed to classify the distinct group of patients with axial spondyloarthritis (SpA) on tumour necrosis factor alpha inhibitors (TNFi) according to the baseline characteristics using a clustering algorithm. METHODS: The clinical characteristics and demographic data of patients with axial SpA included in the Korean College of Rheumatology Biologics and Targeted Therapy registry were investigated. The patterns of disease manifestations were examined using divisive hierarchical cluster analysis. After clustering, we compared the clinical characteristics of patients and the drug survival of TNFi between the classified groups. RESULTS: A total of 1042 patients were analysed. The cluster analysis classified patients into two groups: axial group predominantly showing isolated axial manifestations (n = 828) and extra-axial group more frequently showing extra-axial symptoms (n = 214). Almost all extra-axial symptoms (peripheral arthritis, enthesitis, uveitis, and psoriasis) were more frequently observed in the extra-axial group than in the axial group. Moreover, patients in the extra-axial group had shorter disease duration, later disease onset, and higher disease activity than those in the axial group. The disease activity was comparable between the two groups after 1 year of treatment with TNFi. Interestingly, the extra-axial group had a lower drug survival with TNFi than the axial group (p = 0.001). CONCLUSIONS: Cluster analysis of patients with axial SpA using TNFi classified two distinct clinical phenotypes. These clusters had different TNFi drug survival, clinical characteristics, and disease activity. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13075-021-02647-z. BioMed Central 2021-11-15 2021 /pmc/articles/PMC8591959/ /pubmed/34782006 http://dx.doi.org/10.1186/s13075-021-02647-z Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Lee, Seulkee
Kang, Seonyoung
Eun, Yeonghee
Won, Hong-Hee
Kim, Hyungjin
Cha, Hoon-Suk
Koh, Eun-Mi
Lee, Jaejoon
A cluster analysis of patients with axial spondyloarthritis using tumour necrosis factor alpha inhibitors based on clinical characteristics
title A cluster analysis of patients with axial spondyloarthritis using tumour necrosis factor alpha inhibitors based on clinical characteristics
title_full A cluster analysis of patients with axial spondyloarthritis using tumour necrosis factor alpha inhibitors based on clinical characteristics
title_fullStr A cluster analysis of patients with axial spondyloarthritis using tumour necrosis factor alpha inhibitors based on clinical characteristics
title_full_unstemmed A cluster analysis of patients with axial spondyloarthritis using tumour necrosis factor alpha inhibitors based on clinical characteristics
title_short A cluster analysis of patients with axial spondyloarthritis using tumour necrosis factor alpha inhibitors based on clinical characteristics
title_sort cluster analysis of patients with axial spondyloarthritis using tumour necrosis factor alpha inhibitors based on clinical characteristics
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8591959/
https://www.ncbi.nlm.nih.gov/pubmed/34782006
http://dx.doi.org/10.1186/s13075-021-02647-z
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