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 <40 years (WMD=−1.60, 95% CI −1.98 to −1.22; p<0.001). Statins lowered CRP in both controlled before-after studies (standardised mean difference (SMD)=−0.38, 95% CI −0.73 to −0.03; p=0.032) and parallel controlled trials (SMD=−1.45, 95% CI −2.84 to −0.07; p=0.040). After excluding an outlier, the reduction in IL-6 became significant (SMD=−0.32, 95% CI −0.63 to −0.00; p=0.048). ESR was also reduced (SMD=−1.81, 95% CI −3.54 to −0.08; p=0.0406). No significant publication bias was detected. Conclusion Statin therapy may reduce disease activity and inflammation in SLE, with a consistent benefit observed in patients with a mean age <40 years. Significant heterogeneity underscores the need for future rigorously designed, age-stratified randomised trials to confirm these findings and define the target patient population. PROSPERO registration number CRD42025630267
Qian et al. (Thu,) studied this question.