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Войти в исследования Clinical rheumatology · 2026
Exploring clinical subtypes of Chinese patients with psoriatic arthritis based on cluster analysis: a national registry study (CREPAR V).
СтатьяНазвание и аннотация: Перевод в очереди
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Zhao Yaqi, Li Hongbin, Duan Xinwang, Wu Lijun, Wang Yongfu, Liang Xiao, Qiao Lin, Jiang Nan, Huang Can, Zeng Xiaofeng, Leng Xiaomei
Аннотация
OBJECTIVE: This study aimed to identify distinct clinical phenotypes within a Chinese cohort of patients with psoriatic arthritis (PsA).
METHODS: A total of 1074 patient data were analyzed from the Chinese Psoriatic Arthritis Registry (CREPAR). A two-step clustering approach was used to identify patient subtypes based on the unsupervised clustering of baseline clinical characteristics. Kaplan-Meier curves were used to compare long-term remission probabilities across subtypes, and Cox proportional hazards regression models were used to identify independent risk factors.
RESULTS: The cluster analysis identified three subtypes of patients with distinct clinical presentations, laboratory tests, and prognoses. Cluster 1 patients presented with the most extensive and intense polyarticular inflammation, accompanied by a 'concentrated-severe' pattern of dactylitis across multiple sites. Patients in Cluster 2 had the least peripheral joint involvement, with an extremely low incidence of dactylitis (0.8%). Cluster 3 is characterised by dactylitis in almost all patients (98.9%), presenting a extensive pattern with moderate frequency across sites, alongside common peripheral arthritis. A survival analysis revealed highly significant differences between subtypes in the probability curves for non-remission. Across all subtypes, the Cox regression identified the following independent risk factors: a later age at onset of arthritis, a longer duration of psoriasis, and high baseline DAPSA scores.
CONCLUSION: The purpose of this study is to establish a clinical risk framework for Chinese PsA patients. Identification of high-risk patients based on specific joint/dactylitis patterns is crucial to guiding intensive treatment.
METHODS: A total of 1074 patient data were analyzed from the Chinese Psoriatic Arthritis Registry (CREPAR). A two-step clustering approach was used to identify patient subtypes based on the unsupervised clustering of baseline clinical characteristics. Kaplan-Meier curves were used to compare long-term remission probabilities across subtypes, and Cox proportional hazards regression models were used to identify independent risk factors.
RESULTS: The cluster analysis identified three subtypes of patients with distinct clinical presentations, laboratory tests, and prognoses. Cluster 1 patients presented with the most extensive and intense polyarticular inflammation, accompanied by a 'concentrated-severe' pattern of dactylitis across multiple sites. Patients in Cluster 2 had the least peripheral joint involvement, with an extremely low incidence of dactylitis (0.8%). Cluster 3 is characterised by dactylitis in almost all patients (98.9%), presenting a extensive pattern with moderate frequency across sites, alongside common peripheral arthritis. A survival analysis revealed highly significant differences between subtypes in the probability curves for non-remission. Across all subtypes, the Cox regression identified the following independent risk factors: a later age at onset of arthritis, a longer duration of psoriasis, and high baseline DAPSA scores.
CONCLUSION: The purpose of this study is to establish a clinical risk framework for Chinese PsA patients. Identification of high-risk patients based on specific joint/dactylitis patterns is crucial to guiding intensive treatment.