Supplementary file 2_The neuropsychiatric systemic lupus erythematosus biomarker landscape: what blood and cerebrospinal fluid analytes have been studied and how they performed? A systematic review and meta-analysis.docx

Objective<p>This study aims to evaluate biomarkers that discriminate systemic lupus erythematosus patients with and without neuropsychiatric involvement.</p>Methods<p>We searched MEDLINE, Embase, and CENTRAL (inception—March 2024) for studies of blood or cerebrospinal fluid (CSF) analytes in neuropsychiatric systemic lupus erythematosus (NPSLE). Random-effects meta-analyses were conducted for analyte-biofluid pairs with ≥5 independent studies; the remaining data were synthesized narratively.</p>Results<p>A total of 93 studies were included.

Few analyte–biofluid combinations met the criteria for meta-analysis, and most promising biomarkers (intrathecal inflammation, neuronal injury, and reduced neuroprotection) were assessed in only small, heterogeneous studies. The meta-analyses showed higher CSF IL-6 and MCP-1 in NPSLE than non-NPSLE SLE (Hedges’ g 0.81 and 0.66, respectively), a smaller heterogeneous effect for IL-8, and two- to threefold higher odds of NPSLE in patients positive for serum anti-ribosomal P (OR 2.68, 95% CI 2.03–3.53), anti-NR2/NMDAR (2.09, 1.07–4.06), and IgG anticardiolipin (2.36, 1.56–3.59) antibodies.