ArticleBMJ open respiratory research2026
Sarcoidosis relapse risk factors: a single-centre retrospective cluster analysis.
Article in BMJ open respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Clinical Predictors of Relapse-Free Survival in Early Pulmonary Sarcoidosis.Journal of clinical medicine · 2026Article
- Cirrhosis Risk in Sarcoidosis Without Documented Hepatic Involvement-A Large Nationwide Population-Based Cohort Study.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
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9 authors.
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Abstract
backgroundSarcoidosis is a systemic granulomatous disease with an unpredictable course. While corticosteroids are the mainstay of treatment, recurrence is common and influenced by clinical, demographic and therapeutic factors. However, an integrated approach to patient stratification remains underdeveloped. RESEARCH QUESTION: What are the key clinical, demographic and therapeutic factors influencing sarcoidosis recurrence, and how can an integrated risk stratification model improve disease management?
methodsWe conducted a clustering analysis on 160 sarcoidosis patients to identify recurrence risk subgroups. Key variables included age, sex, body mass index, smoking history, Scadding stage, corticosteroid and immunosuppressant use, therapy duration and recurrence. K-means clustering was employed, with the optimal number of clusters determined using silhouette and elbow methods.
resultsThree distinct clusters emerged: Cluster 1 (n=110): predominantly Scadding stage I-II, low recurrence, favourable steroid response, minimal long-term complications. Cluster 0 (n=30): more smokers, advanced disease (Scadding III-IV), high recurrence despite treatment (p=0.003). Cluster 2 (n=20): patients with obesity with systemic symptoms (fatigue, dyspnoea), high recurrence, particularly in women (p=0.02).Multivariate analysis confirmed smoking (OR 2.3, p=0.002), obesity (OR 1.9, p=0.01) and prolonged steroid use (>12 months, OR 2.5, p=0.004) as independent predictors of recurrence. Sex differences were observed, with women showing more extrapulmonary involvement and men a higher risk of pulmonary fibrosis, though sex alone was not a significant predictor (p=0.08).
interpretationDistinct sarcoidosis phenotypes influence recurrence risk, underscoring the need for personalised management. While Cluster 1 may achieve remission with minimal therapy, Clusters 0 and 2 highlight smoking, obesity and advanced disease as recurrence drivers. Targeted interventions, including smoking cessation, weight management and early steroid-sparing therapy, could improve long-term outcomes and reduce disease burden.
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