{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:54:49Z","timestamp":1760144089658,"version":"build-2065373602"},"reference-count":21,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,3,23]],"date-time":"2024-03-23T00:00:00Z","timestamp":1711152000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The objectives were as follows: (a) to identify, among patients with axial spondyloarthritis (axSpA), \u201cclusters\u201d of patients based on the presence of peripheral and extra-musculoskeletal manifestations (EMMs) and (b) to compare the effectiveness of the first anti-TNF drugs across the different clusters after 6 months of follow-up. Methods: An observational and retrospective study of 90 axSpA patients na\u00efve to bDMARDs was conducted. An unsupervised cluster analysis using the \u201ck-means\u201d technique was performed using variables of peripheral and EMMs. Baseline clinical and sociodemographic characteristics were evaluated, and the response to anti-TNF treatment (considering responders as those with an improvement \u22651.1 for the Ankylosing Spondylitis Disease Activity Score (ASDAS) or \u22652.0 for the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)) was compared across the clusters after 6 months of follow-up. Results: Two clusters were identified: cluster 1 (n = 14), with a higher prevalence of peripheral manifestations, inflammatory bowel disease (IBD), and HLA-B27-positive status, and a lower prevalence of uveitis in comparison with cluster 2 (n = 76). Patients from cluster 1 experienced a more pronounced absolute improvement in ASDAS and BASDAI indices after 6 months. The percentage of responders after 6 months of follow-up was superior in cluster 1 compared to cluster 2 (85.7% vs. 48.7%, p = 0.011). Conclusion: This study suggests the existence of two clinical profiles in axSpA patients according to the peripheral and EMMs, with higher rates of anti-TNF effectiveness after 6 months in those with a greater presence of peripheral features.<\/jats:p>","DOI":"10.3390\/jcm13071855","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T12:32:36Z","timestamp":1711369956000},"page":"1855","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Different Therapeutic Response to Anti-TNF Drugs in Patients with Axial Spondyloarthritis Depending on Their Clinical Profile: An Unsupervised Cluster Analysis"],"prefix":"10.3390","volume":"13","author":[{"given":"Carmen","family":"Priego-P\u00e9rez","sequence":"first","affiliation":[{"name":"Medical and Surgical Sciences Department, University of Cordoba, 14071 Cordoba, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1526-0978","authenticated-orcid":false,"given":"Mar\u00eda \u00c1ngeles","family":"Puche-Larrubia","sequence":"additional","affiliation":[{"name":"Medical and Surgical Sciences Department, University of Cordoba, 14071 Cordoba, Spain"},{"name":"Rheumatology Department, Reina Sofia University Hospital, 14004 Cordoba, Spain"},{"name":"Consolidated Group 05, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lourdes","family":"Ladehesa-Pineda","sequence":"additional","affiliation":[{"name":"Medical and Surgical Sciences Department, University of Cordoba, 14071 Cordoba, Spain"},{"name":"Rheumatology Department, Reina Sofia University Hospital, 14004 Cordoba, Spain"},{"name":"Consolidated Group 05, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerusalem","family":"Calvo-Guit\u00e9rrez","sequence":"additional","affiliation":[{"name":"Medical and Surgical Sciences Department, University of Cordoba, 14071 Cordoba, Spain"},{"name":"Rheumatology Department, Reina Sofia University Hospital, 14004 Cordoba, Spain"},{"name":"Consolidated Group 05, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafaela","family":"Ortega-Castro","sequence":"additional","affiliation":[{"name":"Medical and Surgical Sciences Department, University of Cordoba, 14071 Cordoba, Spain"},{"name":"Rheumatology Department, Reina Sofia University Hospital, 14004 Cordoba, Spain"},{"name":"Consolidated Group 05, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5891-5527","authenticated-orcid":false,"given":"Alejandro","family":"Escudero-Contreras","sequence":"additional","affiliation":[{"name":"Medical and Surgical Sciences Department, University of Cordoba, 14071 Cordoba, Spain"},{"name":"Rheumatology Department, Reina Sofia University Hospital, 14004 Cordoba, Spain"},{"name":"Consolidated Group 05, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0962-6072","authenticated-orcid":false,"given":"Nuria","family":"Barbarroja","sequence":"additional","affiliation":[{"name":"Medical and Surgical Sciences Department, University of Cordoba, 14071 Cordoba, Spain"},{"name":"Rheumatology Department, Reina Sofia University Hospital, 14004 Cordoba, Spain"},{"name":"Consolidated Group 05, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7647-6289","authenticated-orcid":false,"given":"Eduardo","family":"Collantes-Est\u00e9vez","sequence":"additional","affiliation":[{"name":"Medical and Surgical Sciences Department, University of Cordoba, 14071 Cordoba, Spain"},{"name":"Consolidated Group 05, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2309-5837","authenticated-orcid":false,"given":"Clementina","family":"L\u00f3pez-Medina","sequence":"additional","affiliation":[{"name":"Medical and Surgical Sciences Department, University of Cordoba, 14071 Cordoba, Spain"},{"name":"Rheumatology Department, Reina Sofia University Hospital, 14004 Cordoba, Spain"},{"name":"Consolidated Group 05, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 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