Systemic lupus erythematosus (SLE) can cause multi-organ inflammation with pervasive fatigue, pain, and mood disorders that often persist despite standard therapy. Because many patients show autonomic dysfunction, vagus nerve stimulation—especially noninvasive transcutaneous VNS (tVNS)—is being explored to dampen inflammation via cholinergic anti-inflammatory pathways. Early studies suggest tVNS can reduce fatigue and pain without serious adverse events, but mixed findings from broad autoimmune reviews highlight the need for an SLE-specific evidence synthesis. This protocol proposes a dedicated systematic review and meta-analysis.
Registered on PROSPERO and aligned with PRISMA-P, the review will include randomized controlled trials and observational studies comparing tVNS with sham or no intervention in adults with SLE. Fatigue is the primary outcome, with pain, mood, quality of life, disease activity, and safety as secondaries. Researchers will perform comprehensive database and registry searches through February 2026, apply dual screening, standard risk-of-bias and certainty grading, and synthesize results via meta-analysis or narrative methods with planned subgroup and sensitivity analyses. Despite small samples and protocol variability, the goal is to deliver the first SLE-focused, evidence-based appraisal of tVNS to inform care and future trials.
Reference: Sun H, Hu H, Bian Z, et al. Evaluating the efficacy and safety of transcutaneous vagus nerve stimulation for systemic lupus erythematosus: a protocol for a systematic review and meta-analysis. BMJ Open. 2025;15(10):e098576. doi: 10.1136/bmjopen-2024-098576.
