TY - JOUR T1 - Association Between Cigarette Smoking and Systemic Lupus Erythematosus - an Updated Multivariate Bayesian Metaanalysis JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.190733 SP - jrheum.190733 AU - Monica Hui Yan Chua AU - Irene Ai Ting Ng AU - Mike W.L. Cheung AU - Anselm Mak Y1 - 2019/12/01 UR - http://www.jrheum.org/content/early/2019/11/25/jrheum.190733.abstract N2 - Objective The association between cigarette smoking and the risk of systemic lupus erythematosus (SLE) remains controversial. Additionally, the impact of the change of smokers’ demographics on the risk of development of SLE over time was not formally addressed. We aimed to examine the association between cigarette smoking and the risk of SLE by performing an updated metaanalysis. Methods A literature search using the keywords including “lupus’, “smoking”, “cigarette”, “environmental”, “autoimmune” and “connective tissue disease” was performed in computerized databases to identify studies addressing the relationship between cigarette smoking and SLE occurrence. A Bayesian meta-analysis was conducted by computing the log odds ratios (OR) between current and never smokers, and between former and never smokers. The average log ORs (subsequently converted to ORs) and their corresponding 95% credible intervals (CI) were calculated. The impact of publication time, gender and age of SLE patients on the effect sizes was examined by multivariate meta-regression. Results Data aggregation of 12 eligible studies comprising 3,234 individuals who developed SLE and 288,336 control subjects revealed a significant association between SLE occurrence and current-smoking status (OR 1.54, 95% CI [1.06, 2.25]), while only a non-significant trend was demonstrated between SLE occurrence and former-smoking status (OR 1.39, 95% CI [0.95, 2.08]). Publication time, gender and the mean age of SLE patients did not explain the heterogeneity of the effect sizes. Conclusion Current-smoking status is associated with the risk of SLE. Gender and the age of SLE patients had no significant impact on the risk of SLE over time. ER -