{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T12:24:30Z","timestamp":1777983870419,"version":"3.51.4"},"reference-count":35,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T00:00:00Z","timestamp":1702512000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Scleroderma and Related Disorders"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To conduct an exploratory cluster analysis of systemic sclerosis patients from the baseline data of the Indian systemic sclerosis registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients satisfying American College of Rheumatology-European League Against Rheumatism classification criteria for systemic sclerosis were included. The clusters formed using clinical and immunological parameters were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of the 564 systemic sclerosis registry participants, 404 patients were included. We derived four clusters of which three were anti-topoisomerase I predominant and one was anti-centromere antibody 2 dominant. Cluster 1 ( n-82 (20.3%)) had diffuse cutaneous systemic sclerosis patients with the most severe skin disease, anti-topoisomerase I positivity, males, younger age of onset and high prevalence of musculoskeletal, vasculopathic and gastrointestinal features. Cluster 2 ( n-141 (34.9%)) was also diffuse cutaneous systemic sclerosis and anti-topoisomerase I predominant but with less severe skin phenotype than cluster 1 and a lesser prevalence of musculoskeletal, vasculopathic and gastrointestinal features. Cluster 3 ( n-119 (29.5%)) had limited cutaneous systemic sclerosis patients with anti-topoisomerase I positivity along with other antibodies. The proximal muscle weakness was higher and digital pitting scars were lower, while other organ involvement was similar between clusters 2 and 3. Cluster 4 ( n-62 (15.30%)) was the least severe group with limited cutaneous systemic sclerosis and anti-centromere antibody predominance. Age of onset was higher with low musculoskeletal disease and a higher presence of upper gastrointestinal features. The prevalence of interstitial lung disease was similar in the three anti-topoisomerase I predominant clusters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>With exploratory cluster analysis, we confirmed the possibility of subclassification of systemic sclerosis along a spectrum based on clinical and immunological characteristics. We also corroborated the presence of anti-topoisomerase I in limited cutaneous systemic sclerosis and the association of interstitial lung disease with anti-topoisomerase I.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23971983231215470","type":"journal-article","created":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T05:53:50Z","timestamp":1702533230000},"page":"29-37","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Exploratory clinical subgroup clustering in systemic sclerosis: Results from the Indian Progressive Systemic Sclerosis Registry"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7301-4970","authenticated-orcid":false,"given":"Shery Susan","family":"Philip","sequence":"first","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, St. John\u2019s Medical College Hospital, Bengaluru, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramya","family":"Janardana","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, St. John\u2019s Medical College Hospital, Bengaluru, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7666-1361","authenticated-orcid":false,"given":"Padmanabha","family":"Shenoy","sequence":"additional","affiliation":[{"name":"Centre for Arthritis and Rheumatism Excellence (CARE), Cochin, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengappa","family":"Kavadichanda","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Devender","family":"Bairwa","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geetabali","family":"Sircar","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Institute of Post-Graduate Medical Education & Research and S. 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