Identification of novel clinical subtypes in patients with microscopic polyangiitis using cluster analysis: multicenter REVEAL cohort study
IntroductionThis study aimed to identify new clinical phenotypes of microscopic polyangiitis (MPA) using a principal components analysis (PCA)-based cluster analysis.MethodsA total of 189 patients with MPA between May 2005 and December 2021 were enrolled from a multicenter cohort in Japan (REVEAL co...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1450153/full |
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| author | Ayana Okazaki Shogo Matsuda Takuya Kotani Keisuke Fukui Keisuke Fukui Takaho Gon Ryu Watanabe Atsushi Manabe Mikihito Shoji Keiichiro Kadoba Ryosuke Hiwa Wataru Yamamoto Motomu Hashimoto Tohru Takeuchi |
| author_facet | Ayana Okazaki Shogo Matsuda Takuya Kotani Keisuke Fukui Keisuke Fukui Takaho Gon Ryu Watanabe Atsushi Manabe Mikihito Shoji Keiichiro Kadoba Ryosuke Hiwa Wataru Yamamoto Motomu Hashimoto Tohru Takeuchi |
| author_sort | Ayana Okazaki |
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| description | IntroductionThis study aimed to identify new clinical phenotypes of microscopic polyangiitis (MPA) using a principal components analysis (PCA)-based cluster analysis.MethodsA total of 189 patients with MPA between May 2005 and December 2021 were enrolled from a multicenter cohort in Japan (REVEAL cohort). Categorical PCA and cluster analysis were performed based on clinical, laboratory, and radiological findings. Clinical characteristics and outcomes, including all-cause mortality, respiratory-related mortality, end-stage renal disease (ESRD), and relapse were compared between each cluster.ResultsEleven clinical variables were transformed into four components using categorical PCA and synthetic variables were created. Additionally, a cluster analysis was performed using these variables to classify patients with MPA into subgroups. Four distinct clinical subgroups were identified: Cluster 1 included the renal involvements and diffuse alveolar hemorrhage (DAH)-dominant group (N=33). Cluster 2 comprised the elderly onset systemic inflammation group (N=75). Cluster 3 included patients in the younger-onset limited-organ disease group (N=45). Cluster 4 was comprised of an ILD-predominant group without kidney involvement (N=36). 61 patients died during follow-up, with 32 dying of respiratory-related causes. Additionally, 19 patients developed ESRD and 70 relapsed. Cluster 1 showed the worst ESRD-free survival and relapse rates, whereas Cluster 2 showed the worst overall survival and respiratory-related death-free survival rates among the four groups.ConclusionsOur study identified four unique subgroups with different MPA outcomes. Individualized treatments for each subgroup may be required to improve the prognosis of MPA. |
| format | Article |
| id | doaj-art-b5e019f087814a4f9df60138ac9ea9b1 |
| institution | Kabale University |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Immunology |
| spelling | doaj-art-b5e019f087814a4f9df60138ac9ea9b12025-01-20T05:23:55ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-01-011510.3389/fimmu.2024.14501531450153Identification of novel clinical subtypes in patients with microscopic polyangiitis using cluster analysis: multicenter REVEAL cohort studyAyana Okazaki0Shogo Matsuda1Takuya Kotani2Keisuke Fukui3Keisuke Fukui4Takaho Gon5Ryu Watanabe6Atsushi Manabe7Mikihito Shoji8Keiichiro Kadoba9Ryosuke Hiwa10Wataru Yamamoto11Motomu Hashimoto12Tohru Takeuchi13Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical and Pharmaceutical University, Takatsuki, JapanDepartment of Internal Medicine IV, Division of Rheumatology, Osaka Medical and Pharmaceutical University, Takatsuki, JapanDepartment of Internal Medicine IV, Division of Rheumatology, Osaka Medical and Pharmaceutical University, Takatsuki, JapanFaculty of Societal Safety Sciences, Kansai University, Takatsuki, JapanDepartment of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, Takatsuki, JapanDepartment of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, JapanDepartment of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, JapanDepartment of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, JapanDepartment of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, JapanDepartment of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, JapanDepartment of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, JapanDepartment of Health Information Management, Kurashiki Sweet Hospital, Kurashiki, JapanDepartment of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, JapanDepartment of Internal Medicine IV, Division of Rheumatology, Osaka Medical and Pharmaceutical University, Takatsuki, JapanIntroductionThis study aimed to identify new clinical phenotypes of microscopic polyangiitis (MPA) using a principal components analysis (PCA)-based cluster analysis.MethodsA total of 189 patients with MPA between May 2005 and December 2021 were enrolled from a multicenter cohort in Japan (REVEAL cohort). Categorical PCA and cluster analysis were performed based on clinical, laboratory, and radiological findings. Clinical characteristics and outcomes, including all-cause mortality, respiratory-related mortality, end-stage renal disease (ESRD), and relapse were compared between each cluster.ResultsEleven clinical variables were transformed into four components using categorical PCA and synthetic variables were created. Additionally, a cluster analysis was performed using these variables to classify patients with MPA into subgroups. Four distinct clinical subgroups were identified: Cluster 1 included the renal involvements and diffuse alveolar hemorrhage (DAH)-dominant group (N=33). Cluster 2 comprised the elderly onset systemic inflammation group (N=75). Cluster 3 included patients in the younger-onset limited-organ disease group (N=45). Cluster 4 was comprised of an ILD-predominant group without kidney involvement (N=36). 61 patients died during follow-up, with 32 dying of respiratory-related causes. Additionally, 19 patients developed ESRD and 70 relapsed. Cluster 1 showed the worst ESRD-free survival and relapse rates, whereas Cluster 2 showed the worst overall survival and respiratory-related death-free survival rates among the four groups.ConclusionsOur study identified four unique subgroups with different MPA outcomes. Individualized treatments for each subgroup may be required to improve the prognosis of MPA.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1450153/fullthe running head: clinical subtypes in MPA (microscopic polyangiitis)principal component analysiscluster analysisprognosisreal world evidence |
| spellingShingle | Ayana Okazaki Shogo Matsuda Takuya Kotani Keisuke Fukui Keisuke Fukui Takaho Gon Ryu Watanabe Atsushi Manabe Mikihito Shoji Keiichiro Kadoba Ryosuke Hiwa Wataru Yamamoto Motomu Hashimoto Tohru Takeuchi Identification of novel clinical subtypes in patients with microscopic polyangiitis using cluster analysis: multicenter REVEAL cohort study Frontiers in Immunology the running head: clinical subtypes in MPA (microscopic polyangiitis) principal component analysis cluster analysis prognosis real world evidence |
| title | Identification of novel clinical subtypes in patients with microscopic polyangiitis using cluster analysis: multicenter REVEAL cohort study |
| title_full | Identification of novel clinical subtypes in patients with microscopic polyangiitis using cluster analysis: multicenter REVEAL cohort study |
| title_fullStr | Identification of novel clinical subtypes in patients with microscopic polyangiitis using cluster analysis: multicenter REVEAL cohort study |
| title_full_unstemmed | Identification of novel clinical subtypes in patients with microscopic polyangiitis using cluster analysis: multicenter REVEAL cohort study |
| title_short | Identification of novel clinical subtypes in patients with microscopic polyangiitis using cluster analysis: multicenter REVEAL cohort study |
| title_sort | identification of novel clinical subtypes in patients with microscopic polyangiitis using cluster analysis multicenter reveal cohort study |
| topic | the running head: clinical subtypes in MPA (microscopic polyangiitis) principal component analysis cluster analysis prognosis real world evidence |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1450153/full |
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