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Objective <p>This study aimed to identify distinct clinical phenotypes within a Chinese cohort of patients with psoriatic arthritis (PsA).</p> Methods <p>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.</p> Results <p>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.</p> Conclusion <p>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.</p>

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Exploring clinical subtypes of Chinese patients with psoriatic arthritis based on cluster analysis: a national registry study (CREPAR V)

  • 期刊论文

  • 发表日期：

    2026年3月3日

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  • Yaqi Zhao,
  • Hongbin Li,
  • Xinwang Duan,
  • Lijun Wu,
  • Yongfu Wang,
  • Xiao Liang,
  • Lin Qiao,
  • Nan Jiang,
  • Can Huang,
  • Xiaofeng Zeng,
  • Xiaomei Leng

摘要

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.