Prevalence of migraine in systemic lupus erythematosus: A meta-analysis

Systemic lupus erythematosus (SLE) is an autoimmune disorder with a wide range of clinical manifestations, including neurological issues in about 25%-75% of cases. Among the neurological involvement cases, most cases show migraine. However, the prevalence of migraine varied worldwide, and in some studies, a higher incidence of migraine in SLE cases was reported compared to healthy controls. In the present study, we adopted a meta-analysis approach to find out the prevalence of migraine in SLE patients worldwide and investigate whether migraine frequency is more prevalent in SLE patients than controls.

Various literature databases such as Scopus, PubMed, Science Direct, and Google Scholar were screened for eligible studies. The last search was performed on January 21, 2023. Publication biases were accessed by Egger's regression analysis and funnel plots. Cochrane Q statistics and I2 values explored the presence or absence of heterogeneity. All statistical analysis of meta-analysis was performed in comprehensive meta-analysis software v3.

Based on predefined inclusion and exclusion criteria, 17 reports comprising 2901 SLE patients and 575 healthy controls were considered in the present study. The meta-analysis revealed the prevalence of migraine to be 34.8%. Furthermore, migraine was more prevalent in SLE patients than healthy controls (OR: 1.964, p = 0.000, 95% CI = 1.512-2.550). Similar trends were also observed while considering another 10 independent reports those were not disclosed about the migraine diagnosis criteria (number of reports: 27, SLE: 3473, HC: 741, prevalence: 33.5%, SLE vs HC: OR = 2.107, p = 0.000, 95% CI = 1.672-2.655). Subgroup analysis demonstrated that SLE patients from South America had a higher prevalence of migraine (56.2%).

About one-third of SLE patients experience migraine worldwide. The prevalence of migraine is more frequent in SLE patients than the healthy controls.