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Systemic immune-inflammation index and systemic inflammation response index correlate with disease activity in systemic lupus erythematosusInflammation markers are higher in lupus patients than in healthy people

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Key Takeaway
Note that SII correlates with SLEDAI activity in SLE, but SIRI association was not significant.

This meta-analysis evaluated the correlation of the systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) with disease activity in systemic lupus erythematosus. The analysis included eleven studies comparing individuals with SLE to healthy controls. Safety data, adverse events, and discontinuations were not reported. Funding or conflicts of interest were not reported.

Results indicated that SII was markedly higher in SLE patients than in healthy controls, with a standard mean difference of 0.961 (95% CI 0.632-1.291; p < 0.001). Similarly, SIRI was elevated in those with SLE, showing a standard mean difference of 0.761 (95% CI 0.320-1.203; p = 0.001).

Regarding disease activity measured by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), SII had a statistically significant positive association with scores, with a correlation coefficient of 0.322 (95% CI 0.146-0.478; p < 0.001). In contrast, SIRI did not present a significant association with SLEDAI, with a correlation coefficient of 0.133 (95% CI -0.119 to 0.369; p = 0.302). The authors note that the setting was not reported and causality was not established.

People with systemic lupus erythematosus often feel tired and in pain. Their bodies fight a constant battle against inflammation. A recent look at eleven studies found that two specific inflammation markers are much higher in these patients than in healthy people. One marker, called SII, was significantly elevated. The other, SIRI, was also higher in those with the disease.

The analysis looked at how these markers relate to disease activity. Doctors use a score called SLEDAI to measure how active the lupus is. The data showed a clear link between the SII marker and this activity score. When the marker went up, the disease activity score went up too. This suggests the marker reflects the real state of the illness.

However, the other marker, SIRI, did not show a strong connection to disease activity in this group. The findings come from a mix of studies, so results can vary. Still, the difference between sick patients and healthy controls is clear. These numbers might help doctors see the disease more clearly.

What this means for you:
Inflammation markers are higher in lupus patients and track with disease activity.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
OBJECTIVE: The objective of this meta-analysis was to assess the relationships of the systemic immune-inflammation index (SII) and the systemic inflammation response index (SIRI) with systemic lupus erythematosus (SLE) and to determine the correlation of these indices with disease activity as measured by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). METHODS: We performed a systematic search of Medline, Embase, and the Web of Science databases to identify eligible studies. Standardized mean differences (SMDs) were calculated to compare SII and SIRI between individuals with SLE and healthy controls. Pooled correlation coefficients were used to estimate the strength of the associations between SII, SIRI, and SLEDAI scores. RESULTS: Eleven studies qualified for inclusion in the meta-analysis. The aggregated analyses indicated that SII was markedly higher in SLE patients than in healthy controls (SMD 0.961; 95% CI 0.632-1.291; p < 0.001), a finding that remained consistent irrespective of data type, study sample size, or lupus nephritis status. Similarly, SIRI was elevated in those with SLE (SMD 0.761; 95% CI 0.320-1.203; p = 0.001). Analysis of correlation revealed that SII had a statistically significant positive association with SLEDAI scores (correlation coefficient 0.322; 95% CI 0.146-0.478; p < 0.001), supporting its value as a marker of increased disease activity. In contrast, SIRI did not present a significant association with SLEDAI (correlation coefficient 0.133; 95% CI -0.119 to 0.369; p = 0.302). CONCLUSION: This meta-analysis provides evidence that both SII and SIRI are significantly increased in patients with SLE compared to healthy controls, supporting their utility as inflammatory biomarkers in SLE. Additionally, SII demonstrated a moderate positive correlation with disease activity, emphasizing its relevance for evaluating SLE severity.
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