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Clustering the clinical course of chronic urticaria using a longitudinal database: Effects on chronic urticaria remission
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  • Young-Min Ye,
  • Jiwon Yoon,
  • Seong-Dae Woo,
  • Jae-Hyuk Jang,
  • Youngsoo Lee,
  • Hyun-Young Lee,
  • Yoo Seob Shin,
  • Dong Ho Nam,
  • Hae-Sim Park
Young-Min Ye
Ajou University School of Medicine and Graduate School of Medicine
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Jiwon Yoon
Ajou University School of Medicine and Graduate School of Medicine
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Seong-Dae Woo
Ajou University School of Medicine and Graduate School of Medicine
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Jae-Hyuk Jang
Ajou University School of Medicine and Graduate School of Medicine
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Youngsoo Lee
Ajou University School of Medicine and Graduate School of Medicine
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Hyun-Young Lee
Ajou University Hospital
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Yoo Seob Shin
Ajou University School of Medicine and Graduate School of Medicine
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Dong Ho Nam
Ajou University School of Medicine and Graduate School of Medicine
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Hae-Sim Park
Ajou University School of Medicine and Graduate School of Medicine
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Abstract

Background: 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 for the initial 3 months of treatment to investigate time to remission and relapse rates and to identify predictors for CU remission. Methods: In total, 4552 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 = 1786), with medium-to-low disease activity (cluster 2, n = 1031), with consistently medium disease activity (cluster 3, n = 1332), or with consistently high disease activity (cluster 4, n = 403). Mean age, treatment duration, peripheral neutrophil counts, total IgE, and complements levels were significantly higher for cluster 4 than the other three clusters. Median times to remission were also different among the four clusters (2.1 vs 3.3 vs 6.4 vs 9.4 years, respectively, P < .001). Sensitization to house dust mites (≥ class 3) and female sex were identified as significant predictors of CU remission. Around 20% of patients who achieved CU remission experienced relapse. Conclusion: In this study, we identified four CU patient clusters by analyzing medication scores during the first 3 months of treatment and found that sensitization to house dust mites and female sex can affect CU prognosis.