Statin therapy in systemic lupus erythematosus: a meta-analysis of disease activity and inflammatory biomarkers

OBJECTIVE: Dyslipidaemia in systemic lupus erythematosus (SLE) contributes to pathogenesis and cardiovascular risk. The effect of statin therapy on SLE disease activity remains controversial. This meta-analysis systematically evaluates the impact of statins on SLE activity and inflammatory markers. METHODS: This study adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A systematic literature search across multiple databases was conducted up to 13 November 2024. Study selection, data extraction and quality assessment were performed independently by two reviewers. Meta-analysis was conducted using R software, evaluating outcomes including SLE Disease Activity Index (SLEDAI), C-reactive protein (CRP), interleukin-6 (IL-6) and erythrocyte sedimentation rate (ESR). RESULTS: From 3596 identified records, 12 studies were included. Statins significantly reduced SLEDAI in controlled before-after studies (weighted mean difference (WMD)=-0.70, 95% CI -1.16 to -0.23; p=0.0037), but not in parallel controlled trials (WMD=-0.58, 95% CI -1.74 to 0.59; p=0.330; I² = 81.1%). Subgroup analysis showed a pronounced reduction in patients with a mean age