Prevalence of Arthritis in Systemic Lupus Erythematosus in Pakistan: A Systematic Review and Meta-analysis

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations that significantly affect patients’ quality of life. Arthritis is one of the most common and disabling manifestations of SLE. This study aimed to provide a comprehensive estimate of the prevalence of arthritis among patients with SLE in Pakistan and to evaluate regional and temporal variations. Two independent reviewers selected eligible studies, extracted the data, and assessed the risk of bias. A random-effects meta-analysis was performed to account for between-study heterogeneity. Subgroup analyses and meta-regression were conducted to explore potential sources of study-level variation. A total of 10 studies involving 1,292 participants were included in the meta-analysis. The pooled prevalence of arthritis among patients with SLE was 60.68% (95% CI: 46.41%–74.08%). Subgroup analysis showed that the highest prevalence was observed in Khyber Pakhtunkhwa (KP) (78.13%; 95% CI: 74.83%–81.11%), followed by Punjab (58.94%; 95% CI: 38.19%–78.15%) and Sindh (57.28%; 95% CI: 29.43%–82.82%). Studies published after 2010 reported a higher pooled prevalence (67.89%; 95% CI: 54.47%–79.95%) than those published before 2010 (42.11%; 95% CI: 34.74%–49.67%). The high prevalence of arthritis among patients with SLE in Pakistan highlights the need for improved screening, early diagnosis, and effective management strategies to reduce disease burden and improve patient outcomes. This systematic review and meta-analysis was registered with PROSPERO (CRD42023420108) on May 1st, 2023.