Impact of overweight and obesity on disease activity and remission in systemic lupus erythematosus: A systematic review and meta-analysis protocol

Background: Systemic lupus erythematosus (SLE) is an autoimmune and inflammatory disease that requires treatment with hydroxychloroquine and glucocorticoids. Glucocorticoids are responsible for adverse effects such as increased weight, which can modify the severity and chronicity of autoimmune pathologies. Aim: To summarize scientific evidence regarding the impact of overweight and obesity on disease activity and remission in SLE. Methods: The protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-analysis Protocol (PRISMA-P) and published in the International Prospective Register of Systematic Reviews database (PROSPERO—CRD42021268217). PubMed, Scopus, Embase, and Google Scholar will be searched for observational studies including adult patients with SLE who were overweight and obese or not, that included disease activity or remission as outcomes. The search is planned for May 2023. Three independent authors will select the eligible articles and extract their data. Subsequently, three authors will independently extract data from each included study using an extraction form created by the researchers. Methodological quality analyses will be performed using the modified Newcastle-Ottawa scale. The results will be presented as a narrative synthesis according to the synthesis without a meta-analysis reporting guideline (SWiM). Meta-analysis will be conducted where appropriate using random-effects models. Expected results: This review will identify the impact of overweight and obesity on the clinical features of SLE, helping clinicians manage disease activity and remission, both important to optimize disease outcomes and patient quality of life.