en Biomarkers (diagnosis & treatment) Biomarkers (diagnosis & treatment) Original Article Original Article <p style="text-align: justify;"><span style="font-size:12px;"><span style="font-family:Tahoma;"><span style="line-height:14.0pt">In systemic lupus erythematosus (SLE), thrombotic events represent a high-risk manifestation associated with autoantibody-induced damage. This underscores the necessity of utilizing biomarkers to assess thrombotic risk and monitor the thrombotic status of patients. D-dimer is a widely used and inexpensive marker routinely-used to assess coagulation disorders. A systematic literature search was conducted from 1990-2024 using the PubMed, Scopus, and Web of Science databases. Included articles reported D-dimer serum levels in both SLE patients and healthy individuals. Data were analyzed using standard mean difference (SMD) with a 95% confidence interval using random effect models. Heterogeneity was assessed based on the Cochran chi-square and I² statistic. Article quality was assessed via the Newcastle-Ottawa scale. This study incorporated data from 14 studies, encompassing individuals diagnosed with SLE and 1785 healthy participants serving as controls. The results indicated a significant increase in serum D-dimer level in the SLE group compared to the control group (SMD= 0.74, 95% CI 0.49, 1.00, p < 0.001; I² =87.47%, p < 0.001). Moreover, patients with high SLE disease activity had higher D-dimer levels compared to those with low SLE disease activity (SMD=0.78, 95% CI 0.46, 1.11; I²=0, p=0.77). Moreover, a significant positive correlation was found between SLE disease activity and D-dimer concentrations (r=0.45, 95% CI 0.34, 0.55, p<0.0001). D-dimer may serve as an indicator of thrombotic status and disease severity in SLE patients. Establishing D-dimer as a reliable biomarker for tracking SLE activity will require well-designed prospective studies that consider standardized assays, control for confounding factors, and incorporate predictive modelling.</span></span></span></p> D-dimer, systemic lupus erythematosus, disease activity 1240 1249 http://ijmcmed.org/browse.php?a_code=A-10-8362-1&slc_lang=en&sid=1 Zahra Geraili geraili.stat@gmail.com 100319475328460037134 100319475328460037134 No Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. Ayat Abbasi-Shahkouh ayat.abbasi.sh@gmail.com 100319475328460037135 100319475328460037135 No Department of Immunology, Babol University of Medical Sciences, Babol, Iran. Fatemeh Niksolat fniksolat@yahoo.com 100319475328460037136 100319475328460037136 No Department of Internal Medicine and Rheumatology, Orthopedic Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Nasim Hafezi nsm.hafezi@gmail.com 100319475328460037137 100319475328460037137 Yes Cellular and Molecular Biology Research Center, Babol University of Medical Sciences, Babol, Iran.