Machine learning identifies clusters of longitudinal autoantibody profiles predictive of systemic lupus erythematosus disease outcomes

Autor: May Yee Choi, Irene Chen, Ann Elaine Clarke, Marvin J Fritzler, Katherine A Buhler, Murray Urowitz, John Hanly, Yvan St-Pierre, Caroline Gordon, Sang-Cheol Bae, Juanita Romero-Diaz, Jorge Sanchez-Guerrero, Sasha Bernatsky, Daniel J Wallace, David Alan Isenberg, Anisur Rahman, Joan T Merrill, Paul R Fortin, Dafna D Gladman, Ian N Bruce, Michelle Petri, Ellen M Ginzler, Mary Anne Dooley, Rosalind Ramsey-Goldman, Susan Manzi, Andreas Jönsen, Graciela S Alarcón, Ronald F van Vollenhoven, Cynthia Aranow, Meggan Mackay, Guillermo Ruiz-Irastorza, Sam Lim, Murat Inanc, Kenneth Kalunian, Søren Jacobsen, Christine Peschken, Diane L Kamen, Anca Askanase, Jill P Buyon, David Sontag, Karen H Costenbader
Přispěvatelé: Clinical Immunology and Rheumatology, AII - Inflammatory diseases, AMS - Musculoskeletal Health, Rheumatology
Rok vydání: 2023
Předmět:
Zdroj: Annals of the rheumatic diseases. BMJ Publishing Group
Choi, M Y, Chen, I, Clarke, A E, Fritzler, M J, Buhler, K A, Urowitz, M, Hanly, J, St-Pierre, Y, Gordon, C, Bae, S-C, Romero-Diaz, J, Sanchez-Guerrero, J, Bernatsky, S, Wallace, D J, Isenberg, D A, Rahman, A, Merrill, J T, Fortin, P R, Gladman, D D, Bruce, I N, Petri, M, Ginzler, E M, Dooley, M A, Ramsey-Goldman, R, Manzi, S, Jönsen, A, Alarcón, G S, van Vollenhoven, R F, Aranow, C, MacKay, M, Ruiz-Irastorza, G, Lim, S, Inanc, M, Kalunian, K, Jacobsen, S R, Peschken, C, Kamen, D L, Askanase, A, Buyon, J P, Sontag, D & Costenbader, K H 2023, ' Machine learning identifies clusters of longitudinal autoantibody profiles predictive of systemic lupus erythematosus disease outcomes ', Annals of the Rheumatic Diseases, vol. 82, no. 7, 223808, pp. 927-936 . https://doi.org/10.1136/ard-2022-223808
Annals of the Rheumatic Diseases. BMJ Publishing Group
ISSN: 1468-2060
0003-4967
DOI: 10.1136/ard-2022-223808
Popis: ObjectivesA novel longitudinal clustering technique was applied to comprehensive autoantibody data from a large, well-characterised, multinational inception systemic lupus erythematosus (SLE) cohort to determine profiles predictive of clinical outcomes.MethodsDemographic, clinical and serological data from 805 patients with SLE obtained within 15 months of diagnosis and at 3-year and 5-year follow-up were included. For each visit, sera were assessed for 29 antinuclear antibodies (ANA) immunofluorescence patterns and 20 autoantibodies. K-means clustering on principal component analysis-transformed longitudinal autoantibody profiles identified discrete phenotypic clusters. One-way analysis of variance compared cluster enrolment demographics and clinical outcomes at 10-year follow-up. Cox proportional hazards model estimated the HR for survival adjusting for age of disease onset.ResultsCluster 1 (n=137, high frequency of anti-Smith, anti-U1RNP, AC-5 (large nuclear speckled pattern) and high ANA titres) had the highest cumulative disease activity and immunosuppressants/biologics use at year 10. Cluster 2 (n=376, low anti-double stranded DNA (dsDNA) and ANA titres) had the lowest disease activity, frequency of lupus nephritis and immunosuppressants/biologics use. Cluster 3 (n=80, highest frequency of all five antiphospholipid antibodies) had the highest frequency of seizures and hypocomplementaemia. Cluster 4 (n=212) also had high disease activity and was characterised by multiple autoantibody reactivity including to antihistone, anti-dsDNA, antiribosomal P, anti-Sjögren syndrome antigen A or Ro60, anti-Sjögren syndrome antigen B or La, anti-Ro52/Tripartite Motif Protein 21, antiproliferating cell nuclear antigen and anticentromere B). Clusters 1 (adjusted HR 2.60 (95% CI 1.12 to 6.05), p=0.03) and 3 (adjusted HR 2.87 (95% CI 1.22 to 6.74), p=0.02) had lower survival compared with cluster 2.ConclusionFour discrete SLE patient longitudinal autoantibody clusters were predictive of long-term disease activity, organ involvement, treatment requirements and mortality risk.
Databáze: OpenAIRE
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