DataSheet_1_Incidence and prevalence of tuberculosis in systemic lupus erythematosus patients: A systematic review and meta-analysis.doc

BackgroundSystemic lupus erythematosus (SLE) patients are particularly susceptible to infections, such as pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB). This meta-analysis aimed to determine the incidence and prevalence of tuberculosis (TB) in SLE patients.
MethodsThe Web of Science, PubMed, Cochrane Library, and Chinese National Knowledge Infrastructure databases were searched for articles of relevant studies published from the dates the databases were established until April 30, 2022. The I2 statistic and Q test were used to evaluate heterogeneity among the analysed studies. Random-effects models were utilised and subgroup analyses were conducted for analysis of the study data.
ResultsA total of 35 studies with 46,327 SLE patients were eligible for analysis. The incidence and prevalence of TB among the SLE patients were 1.16 per 100 person-years (95% confidence interval (CI): 0.69-1.93) and 3.59% (95% CI: 2.57%-5.02%), respectively. The pooled prevalence of SLE-PTB and SLE-EPTB was 2.46% (95% CI: 1.73%-3.51%) and 1.42% (95% CI: 0.98%-2.06%), respectively. Subgroup analyses showed that the incidence of SLE-TB was higher in Africa and in countries with a high TB burden than in countries with a low TB burden. The prevalence of SLE-TB was elevated in Asia, in patients taking a mean daily dose of glucocorticoids ≥20 mg, in studies with small sample sizes (n <1000) and ended before 2001.
ConclusionsThe available evidence suggests that both the incidence and prevalence of TB in SLE patients are high. This study provides a more specific understanding of SLE-TB, which can help health policymakers in the development of preventive strategies for reducing the SLE-TB burden.

背景 系统性红斑狼疮（Systemic lupus erythematosus, SLE）患者极易发生感染，如肺结核（pulmonary tuberculosis, PTB）与肺外结核（extrapulmonary tuberculosis, EPTB）。本荟萃分析旨在明确SLE患者中结核（tuberculosis, TB）的发病率与患病率。
方法 检索建库至2022年4月30日发表于Web of Science、PubMed、Cochrane图书馆及中国知网（Chinese National Knowledge Infrastructure）的相关研究文献。采用I2统计量与Q检验评估纳入研究间的异质性，使用随机效应模型进行数据分析，并开展亚组分析。
结果 共计35项符合分析标准的研究、涉及46327例SLE患者被纳入本次分析。SLE患者中结核的发病率为1.16/100人年（95%置信区间（confidence interval, CI）：0.69~1.93），患病率为3.59%（95%CI：2.57%~5.02%）。合并后的SLE合并肺结核与SLE合并肺外结核的患病率分别为2.46%（95%CI：1.73%~3.51%）与1.42%（95%CI：0.98%~2.06%）。亚组分析结果显示，非洲地区与结核高负担国家的SLE-TB发病率高于结核低负担国家。亚洲地区、每日平均服用糖皮质激素（glucocorticoids）剂量≥20mg的患者群体、样本量小于1000的研究以及2001年前结题的研究中，SLE-TB的患病率显著升高。
结论 现有证据表明，SLE患者的结核发病率与患病率均处于较高水平。本研究对SLE-TB的临床特征进行了更为精准的阐释，可为卫生政策制定者制定降低SLE-TB疾病负担的预防策略提供科学依据。