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Identifying damage clusters in patients with systemic lupus erythematosus
Ga Young Ahn1,2, Jiyoung Lee3, Soyoung Won3
1Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea.
International Journal of Rheumatic Diseases
|November 26, 2019
Summary
Systemic lupus erythematosus (SLE) patients were clustered by organ damage. Renal/ocular damage correlated with higher SLE disease activity, while neuropsychiatric damage predicted increased mortality.
Area of Science:
- Rheumatology
- Immunology
- Genetics
Background:
- Systemic lupus erythematosus (SLE) can cause irreversible organ damage.
- Emerging evidence suggests distinct SLE subphenotypes.
- Identifying these subphenotypes is crucial for understanding disease heterogeneity.
Purpose of the Study:
- To identify distinct clusters of organ damage in SLE patients.
- To compare clinical manifestations, disease activity, mortality, and genetic risk scores (GRS) across these clusters.
Main Methods:
- Analysis of the Hanyang BAE lupus cohort (n=1130).
- Exclusion of patients with disease duration <5 years.
- K-means cluster analysis based on the Systemic Lupus International Collaborating Clinics Damage Index.
Main Results:
- Three distinct damage clusters were identified.
- Cluster 2 (renal/ocular damage) showed the highest SLE Disease Activity Index (AMS) scores.
- Cluster 3 (neuropsychiatric/musculoskeletal damage) exhibited the highest mortality rate (14.4%).
Conclusions:
- SLE patients with predominant renal and ocular damage experience higher disease activity.
- Neuropsychiatric damage in SLE is associated with increased mortality risk.
- Genetic risk scores did not significantly differ between damage clusters.
