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. 2021 Sep 19;19(1):394.
doi: 10.1186/s12967-021-03051-6.

Longitudinal analysis of symptom-based clustering in patients with primary Sjogren's syndrome: a prospective cohort study with a 5-year follow-up period

Jennifer Jooha Lee  1 , Young Jae Park  1 , Misun Park  2 , Hyeon Woo Yim  2 , Sung Hwan Park  1 , Seung-Ki Kwok  3
Affiliations

Longitudinal analysis of symptom-based clustering in patients with primary Sjogren's syndrome: a prospective cohort study with a 5-year follow-up period

Jennifer Jooha Lee et al. J Transl Med. .

Abstract

Background: Sjogren's syndrome (SS) is a heterogenous disease with various phenotypes. We aimed to provide a relevant subclassification based on symptom-based clustering for patients with primary (p) SS.

Methods: Data from patients in a prospective pSS cohort in Korea were analysed. Latent class analysis (LCA) was performed using patient reported outcomes, including pain, fatigue, dryness, and anxiety/depression. Clinical and laboratory differences between the classes were analysed. Latent transition analysis (LTA) was applied to the longitudinal data (annually for up to 5 years) to assess temporal stability of the classifications.

Results: LCA identified three classes among 341 patients with pSS (i.e., 'high symptom burden', 'dryness dominant', 'low symptom burden'). Each group had distinct laboratory and clinical phenotypes. LTA revealed that class membership remained stable over time. Baseline class predicted future salivary gland function and damage accrual represented by a Sjogren's syndrome disease damage index.

Conclusion: Symptom-based clustering of heterogenous patients with primary Sjogren's syndrome provided a relevant classification supported by temporal stability over time and distinct phenotypes between the classes. This clustering strategy may provide more homogenous groups of pSS patients for novel treatment development and predict future phenotypic evolvement.

Keywords: Cluster analysis; Latent class analysis; Sjogren’s syndrome.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Item response probabilities at all times. Item response probabilities are depicted for each variable
Fig. 2
Fig. 2
Transition probability matrix. Latent status prevalence and probabilities of transitioning into specific classes are depicted
See this image and copyright information in PMC

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