Prevalence and association of cardiovascular comorbidities in prurigo nodularis: A systematic review and meta-analysis

Summary: Abstract Body: Prurigo nodularis (PN) is a neuroinflammatory disorder characterized by persistent pruritus and nodular lesions, significantly impairing quality of life. Evidence suggests a potential relationship between PN and cardiovascular (CV) comorbidities, but this relationship remains unclear. We conducted a systematic review and meta-analysis to assess the prevalence of CV conditions in PN patients. Embase, PubMed, Scopus, and Cochrane Library databases were systematically searched for English-language studies (June 2024; PROSPERO CRD42024574854). Studies with ≥20 PN-diagnosed individuals reporting CV comorbidities were included; reviews, and qualitative studies were excluded. Pooled prevalence proportions with 95% confidence intervals (CIs) were estimated using a random-effects model (n≥3 studies). Of 496 abstracts screened, 16 full-text articles were reviewed, and 9 studies were included (pooled n=20,381 PN patients). The pooled prevalence of hypertension was 31.2% [95% CI, 14.0%-48.3%; n=5,616] across 6 studies, with high heterogeneity (I2 = 99.88%, p < 0.001). Congestive heart failure (CHF) prevalence was 8.8% [95% CI, 1.5%-16.1%; n=674] across 5 studies, with similarly high heterogeneity (I2 = 99.83%, p < 0.001). Coronary artery disease, reported in 3 studies (range: 2.0%-21.4%; n=1,008), yielded non-positive confidence intervals and a non-significant pooled prevalence estimate. Our findings suggest PN patients may have a considerable burden of CV comorbidities, particularly CHF, which occurs at rates exceeding global estimates for the general (2%-3%) and elderly (4%-5%) populations. Limitations to this meta-analysis include few studies, retrospective designs, and few control groups, limiting comparisons and risk calculation. However, these results highlight the need for additional prospective studies to clarify disease-specific risks and evaluate the need for CV screening approaches in this population. Natalia Chalupczak¹, Carmen Li¹, Christy Chang², Meredith Polaskey¹, Raj Chovatiya¹ 1. Rosalind Franklin University of Medicine and Science Chicago Medical School, North Chicago, IL, United States. 2. University of Illinois Chicago College of Medicine, Chicago, IL, United States. Clinical Research: Epidemiology and Observational Research