Evidence map›Paper›PMID 40821780›Full record

SynthesisFrontiers in immunology2025

Prevalence, incidence, and risk factors for herpes zoster in systemic lupus erythematosus: a systematic review and meta-analysis.

Hong-Fei Wang, Yan Gao, Zheng Lin, Shan Liu, Yi Cao, Qiu-Shuang Li

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Vaccination in systemic lupus erythematosus.Human vaccines & immunotherapeutics · 2026
    Review
  3. Article
  4. Article
  5. Observational
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Hong-Fei WangThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.
Yan GaoDepartment of Rheumatology and Immunology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.
Zheng LinFirst School of Clinical Medicine, Zhejiang Chinese Medicine University, Hangzhou, China.
Shan LiuResearch and Development Department, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.
Yi Cao *The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.
Qiu-Shuang Li *Research and Development Department, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Patients with systemic lupus erythematosus (SLE) are particularly vulnerable to infections, with herpes zoster (HZ) being the most common opportunistic infection. This meta-analysis aimed to systematically review the available literature on the prevalence, incidence, and risk factors of HZ in SLE patients. Methods: A comprehensive search through Embase, PubMed, Web of Science, and Cochrane Library was conducted for studies published up to November 1, 2024. Both observational studies (including cohort, case-control, and cross-sectional) and randomized controlled trials (RCTs) were included, with study types selected according to the specific objectives. Funnel plots and Egger's test were employed to assess publication bias. Hazard ratios (HRs) and odds ratios (ORs) were converted to relative risks (RRs), and pooled estimates were calculated using a fixed-effect or random-effects model. Results: A total of 51 studies with 246, 822 SLE patients were included in this meta-analysis. The pooled prevalence and incidence of SLE-HZ were 12.3% (95%CI 10.5-14.1) and 22.0 cases per 1000 person-years (95%CI 17.4-27.9). Glucocorticoids use (RRs=2.83, 95%CI 2.10-3.81), cyclophosphamide use (RRs=2.52, 95%CI 1.60-3.98), mycophenolate mofetil use (RRs=3.00, 95%CI 1.07-8.40), azathioprine use (RRs=1.40, 95%CI 1.18-1.67), anifrolumab use (RRs=2.59, 95%CI 1.52-4.41), having lymphopenia (RRs=2.31, 95%CI 1.54-3.46), and the presence of comorbid conditions such as renal involvement (RRs= 1.80, 95%CI 1.34-2.42) were identified to increase the risk of HZ in SLE patients. Conclusion: The existing evidence highlights the both high prevalence and incidence of HZ in SLE patients. By identifying risk factors associated with the development of HZ in SLE patients, optimization of management strategies and treatment choices can be achieved. Concurrently, physicians could be better equipped to choose patients who would most likely gain from the HZ vaccine. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024331310, identifier CRD42024331310.

Indexed as

Herpesvirus 3, HumanHerpes ZosterLupus Erythematosus, SystemicHumansImmunosuppressive AgentsIncidencePrevalenceRisk FactorsImmunosuppressive Agentsherpes zosterincidenceprevalencerisk factorsystemic lupus erythematosus

Identifiers

PMID40821780
PMCPMC12354570

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.