Kim Yul Hee, Kim Seung Il, Park Bumhee, Lee Eun-So
Department of Dermatology, Ajou University School of Medicine, Suwon, Korea.
Office of Biostatics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, Korea.
Ann Dermatol. 2023 Apr;35(2):132-139. doi: 10.5021/ad.22.148.
Psoriasis is a complex and heterogeneous disease that widely affects a patient's life. Biological therapy is usually prescribed in patients with severe psoriasis that do not respond to conventional treatment. However, data on the specific patient characteristics receiving biologics are still unavailable.
To classify patients with psoriasis into subgroups with distinct phenotypes through cluster analysis, and to evaluate the differences between the clusters to predict disease prognosis by examining the response to biological therapy.
The clinical characteristics of the patients with psoriasis were investigated and categorized using hierarchical cluster analysis. After clustering, the clinical characteristics of the patients were compared and the initiation of treatment with biologics according to the clusters were evaluated.
A total of 361 patients with psoriasis were classified into two clusters using 16 distinct clinical phenotypes. Group 1 (n=202) consisted of male smokers and alcohol users with higher psoriasis area and severity index (PASI), older age of onset, higher body mass index, and comorbidities including psoriatic arthritis, hypertension, and diabetes when compared to group 2 (n=159). Group 1 had a significantly higher probability of biological treatment initiation than group 2 (=0.039). The measured risk factors for the initiation of biologics compared were PASI (<0.001) and nail involvement (=0.022).
Cluster analysis classified patients with psoriasis into two subgroups according to their clinical characteristics. Predicting the disease prognosis using a combination of specific clinical parameters may aid in the management of the disease.
银屑病是一种复杂的异质性疾病，广泛影响患者生活。生物疗法通常用于对传统治疗无反应的重度银屑病患者。然而，关于接受生物制剂治疗的特定患者特征的数据仍然缺乏。
通过聚类分析将银屑病患者分为具有不同表型的亚组，并通过检查对生物疗法的反应来评估各亚组之间的差异，以预测疾病预后。
采用层次聚类分析对银屑病患者的临床特征进行调查和分类。聚类后，比较患者的临床特征，并评估根据聚类情况启动生物制剂治疗的情况。
共361例银屑病患者使用16种不同的临床表型分为两个亚组。与第2组（n=159）相比，第1组（n=202）由男性吸烟者和饮酒者组成，银屑病面积和严重程度指数（PASI）较高，发病年龄较大，体重指数较高，合并症包括银屑病关节炎、高血压和糖尿病。第1组开始生物治疗的概率明显高于第2组（P=0.039）。比较的生物制剂起始测量风险因素为PASI（P<0.001）和指甲受累情况（P=0.022）。
聚类分析根据银屑病患者的临床特征将其分为两个亚组。结合特定临床参数预测疾病预后可能有助于疾病管理。
