Sjögren's disease & overlap diseases
Identification of distinct subgroups of Sjögren's disease by cluster analysis based on clinical and biological manifestations: data from the cross-sectional Paris-Saclay and the prospective Assessment of Systemic Signs and Evolution of Sjögren's Syndrome (ASSESS) cohorts
Authors' conclusion
On the basis of symptoms and clinical and biological manifestations, we identified three distinct subgroups of patients with Sjögren's disease with different prognoses.
Study context
- Population
- Patients with SjD from two independent cohorts in France: cross-sectional Paris-Saclay (recruited 1999–2022) and prospective ASSESS (recruited 2006–2009)Paris-Saclay 534
- Exposure
- Clusters based on symptoms and clinical and biological manifestations
- Outcome
- Identification of distinct subgroups of SjD by cluster analysis using 26 variables (patient-reported symptoms, clinical and biological manifestations)
Methodological detailsunsupervised multiple correspondence analysis, hierarchical cluster analysis, external validation cohort, two independent cohorts
- Unsupervised multiple correspondence analysis
- Hierarchical cluster analysis
- External validation cohort
- Two independent cohorts
Main finding
As reported in the abstract
Clusters identified
- In both cohorts, hierarchical cluster analysis revealed three distinct subgroups: BALS, HSA and LSAHS
- 3
Observational data: associations, not effects.
Further findings
| Outcome | BALS | HSA | P value |
|---|---|---|---|
| ESSPRI score <5, BALS cluster (ASSESS) · month 60 vs inclusion | P < 0.0001 | ||
| Lymphoma incidence during follow-up (ASSESS) | 3% | 4% | |
| Time to diagnosis after inclusion, median (IQR) | 70 months (42-104) | — not stated in the abstract | |
| Time to diagnosis after inclusion (IQR) | — not stated in the abstract | 23 months (13-83) |
— not stated in the abstract
- ESSPRI score <5, BALS cluster (ASSESS): BALS, month 60 36%
- ESSPRI score <5, BALS cluster (ASSESS): BALS, inclusion 49%
- ESSPRI score <5, BALS cluster (ASSESS): of 186 patients; disease activity and symptom states worsened
- Lymphoma incidence during follow-up (ASSESS): BALS of 186 patients; HSA of 158 patients
History of lymphoma (Paris-Saclay)
- All patients with a history of lymphoma were in the BALS and HSA clusters
Comparison with symptom-only classification (Tarn and colleagues)
- Clustering did not correlate with a previous classification based on symptoms only
Original publication
Identification of distinct subgroups of Sjögren's disease by cluster analysis based on clinical and biological manifestations: data from the cross-sectional Paris-Saclay and the prospective ASSESS cohorts. Lancet Rheumatol. Published 1 March 2024. doi:10.
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