Prevalence and Risk Factors of Relapse in Pulmonary Sarcoidosis: A Systematic Review and Meta-analysis

Abstract

Abstract Background and Aim: Relapses in pulmonary sarcoidosis (PS) adversely affect the clinical management and prognosis of the disease, but there is a paucity of data on their incidence and risks. We aimed to systemically review and meta-analyze the available studies for evaluating the pooled weighted incidence and risk factors for relapse in the disease. Methods: We systematically searched electronic databases, including PubMed, Google Scholar, Scopus and Embase, and performed a manual search to collect eligible studies published until 31 October 2023. The prevalence and risk factors for relapse of PS were analyzed by a random effect model using proportions with 95% confidence intervals (CIs). Results: Of the 1402 records retrieved, 26 studies met the inclusion criteria. All these studies were from tertiary centers. Mean age of the relapse groups was 45.94 years (SD 10.87). The prevalence of relapse in sarcoidosis (843 relapses in 2698 sarcoidosis subjects) varied from 11–67%, with a pooled prevalence of 0.34 [95% CI, 0.28–0.40]. Relapses were more common in blacks than in white individuals [0.72 (0.65–0.79) vs [0.27 (0.20–0.34), p = 0.00]. There were no significant differences in subgroups based on age, sex, location, or type of study. Although not reaching statistically significance, the number of relapses were higher in the female as compared to males [Risk difference 0.05(95% CI: -0.01-0.11, p = 0.09)]. Conclusion: Our study shows a pooled incidence of PS relapse of 34%, suggesting a regular follow-up of the patients for early detection of relapse and improved prognosis of the disease.