Related Experiment Video
Updated: Jun 27, 2026
10:16
Human Circadian Phenotyping and Diurnal Performance Testing in the Real World
Published on: April 7, 2020
Prognostic value of baseline clinical features in SLE: a cluster analysis
Betül Dikkanoğlu Demirok1, Sibel Balci2, Andaç Komaç1
1Division of Rheumatology, Department of Internal Medicine, Kocaeli University School of Medicine, Izmit, Turkey.
Lupus Science & Medicine
|June 25, 2026
Summary
Cluster analysis identified distinct subgroups in systemic lupus erythematosus (SLE) patients at diagnosis and follow-up. Mucocutaneous-predominant SLE may indicate a worse prognosis, emphasizing personalized patient management.
Area of Science:
- Rheumatology
- Immunology
- Clinical Epidemiology
Background:
- Systemic lupus erythematosus (SLE) is a complex autoimmune disease with varied clinical presentations.
- Identifying distinct patient subgroups is crucial for understanding disease heterogeneity and prognosis.
- Previous studies have explored SLE classification, but subgroup identification using cluster analysis requires further investigation.
Purpose of the Study:
- To identify clinical subgroups of SLE patients at diagnosis and last follow-up using cluster analysis.
- To evaluate the prognostic implications of these subgroups for disease activity, organ damage, and mortality.
Main Methods:
- Retrospective cohort study of 199 SLE patients fulfilling 1997 ACR criteria.
- Cluster analysis using Gower distance and Partitioning Around Medoids algorithm based on clinical involvement at diagnosis and last visit.
- Statistical analyses included ANOVA, Kruskal-Wallis, and chi-squared tests using SPSS and R software.
Main Results:
- At diagnosis, three clusters emerged: arthritis-predominant, renal/hematological involvement with high disease activity, and mucocutaneous/hematological involvement.
- At follow-up, four clusters were identified, with a poor-prognosis cluster (Cluster 4') characterized by high Systemic Lupus International Collaborating Clinics (SLICC)/ACR Damage Index (SDI) scores.
- Patients with mucocutaneous-predominant SLE at diagnosis had a twofold increased risk of transitioning to the poor-prognosis cluster; mortality did not differ significantly between clusters.
Conclusions:
- Cluster analysis effectively identifies homogeneous SLE patient subgroups and predicts long-term outcomes.
- Mucocutaneous-predominant SLE onset is associated with a worse prognosis, potentially due to less intensive initial treatment.
- Individualized monitoring and management strategies are essential for SLE patients, particularly those with mucocutaneous manifestations.
