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Clustering the clinical course of chronic urticaria using a longitudinal database: Effects on urticaria remission

Ye, YM  | Yoon, J | Woo, SD | Jang, JH  | Lee, Y  | Lee, HY | Shin, YS  | Nahm, DH  | Park, HS
Allergy, asthma & immunology research, 13(3). : 390-403, 2021
Journal Title
Allergy, asthma & immunology research
Purpose: Little is known about the clinical course of chronic urticaria (CU) and predictors of its prognosis. We evaluated CU patient clusters based on medication scores during the initial 3 months of treatment in an attempt to investigate time to remission and relapse rates for CU and to identify predictors for CU remission. Methods: In total, 4, 552 patients (57.9% female; mean age of 38.6 years) with CU were included in this retrospective cohort study. The K-medoids algorithm was used for clustering CU patients. Kaplan-Meier survival analysis with Cox regression was applied to identify predictors of CU remission. Results: Four distinct clusters were identified: patients with consistently low disease activity (cluster 1, n = 1, 786), with medium-to-low disease activity (cluster 2, n = 1, 031), with consistently medium disease activity (cluster 3, n = 1, 332), or with consistently high disease activity (cluster 4, n = 403). Mean age, treatment duration, peripheral neutrophil counts, total immunoglobulin E, and complements levels were significantly higher for cluster 4 than the other 3 clusters. Median times to remission were also different among the 4 clusters (2.1 vs. 3.3 vs. 6.4 vs. 9.4 years, respectively, P < 0.001). Sensitization to house dust mites (HDMs; at least class 3) and female sex were identified as significant predictors of CU remission. Around 20% of patients who achieved CU remission experienced relapse. Conclusions: In this study, we identified 4 CU patient clusters by analyzing medication scores during the first 3 months of treatment and found that sensitization to HDMs and female sex can affect CU prognosis. The use of immunomodulators was implicated in the risk for CU relapse.

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Journal Papers > School of Medicine / Graduate School of Medicine > Allergy
Ajou Authors
남, 동호  |  박, 해심  |  신, 유섭  |  예, 영민  |  이, 영수  |  장, 재혁
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