Risk of stroke in SLE: a systematic review and meta-analysis.

Jingya Zhang; Weiman Shi; Yaling Xu; Dianming Li; Wu Chen; Lin Huang; Xuanlin Li; Qiao Wang

doi:10.1136/lupus-2026-002161

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Risk of stroke in SLE: a systematic review and meta-analysis.

Jingya Zhang·Weiman Shi·Yaling Xu·Dianming Li·Wu Chen·Lin Huang·Xuanlin Li·Qiao Wang

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Abstract

UNLABELLED: The association between SLE and composite stroke, ischaemic stroke and haemorrhagic stroke remains incompletely understood. This meta-analysis aims to assess the risk of stroke in patients with SLE. METHODS: Data sources included PubMed, Embase, the Cochrane Library and reference lists of included studies. This meta-analysis included cohort studies evaluating whether stroke risk is associated with SLE. The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Risk ratios (RRs) with 95% CIs were pooled using a random-effects model, and publication bias was assessed with funnel plots and Egger's test. RESULTS: A total of 25 cohort studies involving 5 220 837 individuals were included in this meta-analysis, which were published between 2001 and 2026. The pooled analysis demonstrated a significantly increased risk of stroke in patients with SLE (RR of 2.60, 95% CI 2.21 to 3.05, I²=97.9%, p<0.001). The risk of composite stroke (RR of 2.83, 95% CI 2.25 to 3.57, I²=98.0%, p<0.001), ischaemic stroke (RR of 2.34, 95% CI 1.75 to 3.12, I²=97.6%, p<0.001) and haemorrhagic stroke (RR of 2.66, 95% CI 1.57 to 4.49, I²=96.2%, p<0.001) was also increased in SLE. Despite the large heterogeneity, the sensitivity analysis indicated that the results were robust, and there was little evidence of publication bias. CONCLUSION: The risk of composite stroke, ischaemic stroke and haemorrhagic stroke is increased in SLE. PROSPERO REGISTRATION NUMBER: CRD420261294082.

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Humans Lupus Erythematosus, Systemic Stroke Risk Factors Hemorrhagic Stroke Ischemic Stroke Autoimmune Diseases Autoimmunity Cardiovascular Diseases Systemic Lupus Erythematosus Journal Article Systematic Review Meta-Analysis

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Jingya Zhang, Weiman Shi, Yaling Xu, Dianming Li, Wu Chen, Lin Huang, Xuanlin Li, Qiao Wang. 2026-09-15. Risk of stroke in SLE: a systematic review and meta-analysis.. https://doi.org/10.1136/lupus-2026-002161

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Autoimmune Diseases subject Cardiovascular Diseases subject Humans subject Ischemic Stroke subject Journal Article subject Journal Article; Systematic Review; Meta-Analysis resource Meta-Analysis subject Systematic reviews study

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