Efficacy and safety of rituximab in patients with lupus nephritis: A systematic review and meta-analysis.

IF 1.1 4区医学 Q3 UROLOGY & NEPHROLOGY

Clinical nephrology Pub Date : 2024-11-15 DOI:10.5414/CN111197

Zhiming Tang, Yanqin Huang, Yuqian Lin, Rong Wang, Yuming Huang, Haiting Huang, Qiuhong Zhong, Xu Lin

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引用次数: 0

Abstract

Background: Our aim was to systematically evaluate the efficacy and safety of rituximab (RTX) in patients with lupus nephritis (LN).

Materials and methods: PubMed, Embase, China National Knowledge Infrastructure (CNKI), Cochrane Library, and Wanfang Databases were searched to collect literature on the efficacy and safety of RTX in patients with LN. Odds ratios (ORs), weighted mean differences (WMDs), and standardized mean differences (SMDs) were used to represent treatment efficacy and overall outcome. The outcomes included complete renal remission rate, proteinuria, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores, serum creatinine, any adverse events and serious adverse events. We explored the heterogeneity with I2 and assessed publication bias with funnel plot and Egger's test.

Results: Nine studies involving 723 patients (254 in the RTX group and 469 in the control group) were included in our systematic review and meta-analysis. RTX resulted in a higher complete renal remission rate (OR: 2.62; 95% CI 1.43 - 4.79, p = 0.024, I² = 54.7%) than the control group. It significantly decreased SLEDAI scores (WMD = -3.79, 95% CI: -5.78 to -1.8, p < 0.001, I² = 94.7%) as well as proteinuria (WMD = -0.9, 95% CI: -1.6 to -0.2, p < 0.001, I² = 97.6%). There were no significant differences in any adverse events and serious adverse events between the RTX group and control group.

Conclusion: RTX was an effective therapeutic agent in patients with LN, and it did not increase the risk of adverse events compared to the control group.

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利妥昔单抗对狼疮肾炎患者的疗效和安全性：系统回顾与荟萃分析。

背景我们的目的是系统评估利妥昔单抗（RTX）在狼疮性肾炎（LN）患者中的疗效和安全性：检索了PubMed、Embase、中国国家知识基础设施（CNKI）、Cochrane图书馆和万方数据库，以收集有关RTX在LN患者中的疗效和安全性的文献。采用比值比（OR）、加权平均差（WMD）和标准化平均差（SMD）来表示疗效和总体结果。结果包括肾功能完全缓解率、蛋白尿、系统性红斑狼疮疾病活动指数（SLEDAI）评分、血清肌酐、任何不良事件和严重不良事件。我们用 I2 检验了异质性，并用漏斗图和 Egger 检验评估了发表偏倚：我们的系统综述和荟萃分析共纳入了九项研究，涉及 723 名患者（RTX 组 254 人，对照组 469 人）。与对照组相比，RTX 的肾功能完全缓解率更高（OR：2.62；95% CI 1.43 - 4.79，P = 0.024，I2 = 54.7%）。它能明显降低 SLEDAI 评分（WMD = -3.79，95% CI：-5.78 至 -1.8，p < 0.001，I2 = 94.7%）和蛋白尿（WMD = -0.9，95% CI：-1.6 至 -0.2，p < 0.001，I2 = 97.6%）。RTX组与对照组在任何不良事件和严重不良事件方面均无明显差异：RTX对LN患者是一种有效的治疗药物，与对照组相比，RTX不会增加不良事件的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nephrology 医学-泌尿学与肾脏学

CiteScore

2.10

自引率

9.10%

发文量

138

审稿时长

4-8 weeks

期刊介绍： Clinical Nephrology appears monthly and publishes manuscripts containing original material with emphasis on the following topics: prophylaxis, pathophysiology, immunology, diagnosis, therapy, experimental approaches and dialysis and transplantation.