Current rheumatology reviews最新文献

{"title":"Investigating the Effects of Simultaneous Administration of Melatonin and Atorvastatin against High Glucose-Induced Oxidative Stress and Apoptosis in Cultured Chondrocytes.","authors":"Saeed Mehrzadi, Majid Safa, Azam Hosseinzadeh","doi":"10.2174/0115733971311626240828181223","DOIUrl":"https://doi.org/10.2174/0115733971311626240828181223","url":null,"abstract":"<p><strong>Objective: </strong>Osteoarthritis (OA) is a prevalent joint disorder categorized into phenotypic subtypes, including those associated with age, traumatic events, and metabolic syndrome. In the aging population, type 2 diabetes mellitus (T2DM) and osteoarthritis (OA) frequently coexist. This can result in higher rates of disability and a greater financial burden. This study aimed to investigate the protective effects of melatonin and atorvastatin together against oxidative stress and apoptosis induced by high glucose in C28I2 human chondrocytes.</p><p><strong>Material and methods: </strong>After being pretreated for 6 hours with melatonin (10 and 100 μM) and atorvastatin (0.01 and 0.1 μM), C28I2 cells were exposed to a high concentration of D-glucose (75 mM) for 72 hours. The impact of a high D-glucose concentration (75 mM), with or without melatonin and/or atorvastatin, on cell viability, intra-cellular ROS generation, lipid peroxidation level, antioxidant activities, and the expression of proteins, including Bax, Bcl-2, and caspase-3, was analyzed.</p><p><strong>Results: </strong>Melatonin and atorvastatin combination effectively inhibited high glucose-induced cytotoxicity, ROS production, and MDA and mitochondrial membrane potential levels. The combination of melatonin and atorvastatin was more successful in reducing ROS production compared to each of the drugs alone. Melatonin, but not atorvastatin, reversed high glucose-induced alteration in the catalase activity. Furthermore, the combination of melatonin and atorvastatin significantly enhanced the ability of each medication to lower the expression of pro-apoptotic protein Bax.</p><p><strong>Conclusion: </strong>The combination of melatonin and atorvastatin exerted greater protective effects against hyperglycemia-induced toxicity in chondrocytes.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TP53 Gene Polymorphism (Rs1042522) in Rheumatoid Arthritis and Systemic Lupus Erythematosus: An Updated Systematic Review and Meta-Analysis.","authors":"Hamidreza Ebrahimiyan, Elham Madreseh, Maryam Akhtari, Elham Farhadi, Ahmadreza Jamshidi, Mahdi Mahmoudi","doi":"10.2174/0115733971321702240829051809","DOIUrl":"https://doi.org/10.2174/0115733971321702240829051809","url":null,"abstract":"<p><strong>Background: </strong>The p53 protein has important roles in apoptosis, proliferation, and prevention of DNA damage. Several studies have reported that TP53 gene polymorphism is associated with various autoimmune diseases, including Rheumatoid arthritis (RA) and Systemic lupus erythematosus (SLE).</p><p><strong>Objective: </strong>Evaluation of the correlation between TP53 gene rs1042522 polymorphism and RA and SLE risk by meta-analysis.</p><p><strong>Methods: </strong>Databases, including PubMed and Scopus, were searched to find studies assessing the association between TP53 gene polymorphism and RA and SLE risk in different populations up to August 2022. The protocol of this article was registered on the International Prospective Register Of Systematic Reviews (PROSPERO number: CRD42022309655).</p><p><strong>Results: </strong>Herein, 7 case-control studies, including 2498 cases and 3799 controls in the SLE group, and 6 case-control studies comprising 1593 cases and 4460 controls in the RA group that investigated rs1042522 SNP were included in the meta-analysis. Herein, CG genotypes were more frequent in healthy participants compared to SLE patients and may associated with a decreased SLE risk (OR=0.85, CI: 0.76-0.95, P-value <0.006). Besides, dominant and recessive models of CC+ CG vs. GG were also protective for SLE risk (OR=0.85, CI: 0.76-0.95, P-value <0.004).</p><p><strong>Conclusion: </strong>In summary, this study discloses a weak correlation between rs1042522 and a decreased risk of SLE. However, no significant association was found in RA.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoarthritis: An Update on Diagnosis & Management.","authors":"Palak Jhangiani, Swidhi Jain, Kumari Neha, Sharad Wakode","doi":"10.2174/0115733971317490240830101915","DOIUrl":"https://doi.org/10.2174/0115733971317490240830101915","url":null,"abstract":"<p><p>Osteoarthritis (OA) is the most prevalent joint condition. It is a progressively degenerating disease that involves the entire joint, including the articular cartilage, subchondral bone, ligaments, capsule, synovial fluid, and periarticular muscles. Physicians understand that osteoarthritis is diagnosed late during the illness, which may be too late for patients to receive significant benefits from medications that change their condition. The goals of OA therapy are to preserve function while minimizing pain and stiffness. This article focuses on the current and potential treatments for osteoarthritis and various diagnostic methodologies for this disease. In the coming years, despite having numerous treatments for symptomatic relief, the treatment plan should be more specialized because everyone might experience improved outcomes.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the Link between Lung Involvement and Anti-CCP Antibodies in Rheumatoid Arthritis: A Cross-sectional Study.","authors":"Hind El-Kasmi, Taoufik Harzy, Nessrine Akasbi","doi":"10.2174/0115733971298865240812063200","DOIUrl":"https://doi.org/10.2174/0115733971298865240812063200","url":null,"abstract":"<p><strong>Background: </strong>In Rheumatoid Arthritis (RA), pulmonary involvement is one of the most frequent extra-articular manifestations. Several studies have demonstrated an association between RA-related lung disease and the positivity of anti-cyclic citrullinated peptide (anti-CCP) antibodies.</p><p><strong>Objective: </strong>Our aim is to describe the frequency of pulmonary involvement in the RA population and investigate the association between anti-CCP antibodies and diverse lung compartment involvement in RA patients.</p><p><strong>Methods: </strong>An observational retrospective cross-sectional study was conducted, during which data were collected from the medical records of the patients with RA who had been tested for anti-CCP antibodies and had thoracic high resolution computerized tomography (HRCT) evaluation from January 2011 to March 2022. The univariate and multivariate analyses using logistic regression models was performed to calculate odds ratios (ORs) with 95% CIs.</p><p><strong>Results: </strong>A total of 390 patients with RA were included, the mean age of patients was 58.99 ± 12.44 years, with a predominance of females (85.9%). Two hundred and fifty-two (64.6%) patients were positive for anti-CCP antibodies. The frequency of RA-related lung diseases was 14.4% (n=56). The different manifestations observed in the thoracic HRCT included Nodules (67.9%), Interstitial lung disease (ILD) (28.6%), bronchiectasis (25%), fibrosis (21.4%), obliterative bronchiolitis (7.1%), and pleuritis (1.8%). In univariate and multivariate analysis, pulmonary involvement was associated with positive anti-CCP antibodies with an odds ratio (OR) of 5.25 (95% CI: 2.17-12.70, p < 0.0001).</p><p><strong>Conclusion: </strong>The study demonstrated a positive association between anti-CCP antibodies and pulmonary involvement in RA and highlighted the importance of tight monitoring in RA patients with positive anti-CCP for pulmonary complications.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Presentation of Cryoglobulinemic Vasculitis Associated with Primary Sjögren's Syndrome.","authors":"Caroline Metyas, Joshua Donguk Lee, Jenny Ann Jun, Daniel G Arkfeld","doi":"10.2174/0115733971311273240824183333","DOIUrl":"https://doi.org/10.2174/0115733971311273240824183333","url":null,"abstract":"<p><strong>Introduction: </strong>Sjögren's syndrome is a chronic autoimmune disorder that results in dry eyes and mouth. It is rarely associated with cryoglobulinemia, the agglutination of cryoglobulins at cold temperatures that leads to systemic inflammation and organ damage. We have, herein, presented a case of Cryoglobulinemic Vasculitis (CryoVas), which presents as cryoglobulinemic glomerulonephritis and Central Nervous System (CNS) vasculitis and peripheral neuropathy.</p><p><strong>Case report: </strong>A 52-year-old woman with a past medical history of Sjögren's syndrome was admitted to the intensive care unit with severe hyponatremia, orthopnea, and progressive lower extremity weakness, and was found to have an intradural extramedullary hematoma with mass effect in the thoracic spine and diffuse hyperintense cord signal abnormality in thoracic spine suggestive of intermixed proteinaceous or hemorrhagic material. Further testing demonstrated that the patient experienced worsening neuropathy, proteinuria, hematuria, declining renal function, and the presence of cryoglobulins in the blood. After a thorough examination and a renal biopsy, the patient was diagnosed with cryoglobulinemic glomerulonephritis and cryoglobulinemic vasculitis of the spine. The patient was treated with rituximab and pulse-dose steroids, with which the patient exhibited improved renal function and resolution of a previously seen intradural hematoma on repeat MRI.</p><p><strong>Conclusion: </strong>We have, herein, discussed a rare case of cryoglobulinemic vasculitis that has led to a rare CNS manifestation and concomitant cryoglobulinemic glomerulonephritis. This suggests that clinicians should consider cryoglobulinemic vasculitis as the etiology that could manifest with multiorgan involvement, especially in patients with underlying rheumatic diseases.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Specific Features of Juvenile Idiopathic Arthritis Patients' Chemokine Profile: The Data of Case-Control Study Analysis.","authors":"Arseniy V Rybakov, Karina A Yureva, Vitaliy V Khizha, Darya I Kozlova, Lybov S Sorokina, Vyacheslav I Zorin, Aleksei N Kozhevnikov, Mikhail M Kostik","doi":"10.2174/0115733971308074240813060452","DOIUrl":"https://doi.org/10.2174/0115733971308074240813060452","url":null,"abstract":"<p><strong>Background: </strong>Juvenile idiopathic arthritis pathogenesis involves a large number of different immune system cells, which are both sources and targets of chemokines, that affect not only their migration but also survival, proliferation, differentiation, production of all cytokine types, degranulation, and also directly stimulating or suppressing angiogenesis. Studyingthe contribution of chemokines to this disease pathogenesis will make it possible to identify new sensitive and specific markers for its diagnosis and subsequent dynamic monitoring of treatment effectiveness. The study aimed to identify a list of the most informative diagnostic markers from a wide range of juvenile idiopathic arthritis patients' blood plasma chemokines.</p><p><strong>Methods: </strong>The case-control study included 40 diagnosed pathology patients and 20 healthy agematched children. The content of MCP-1/CCL2, MCP-3/CCL7, MIG/CXCL9, MIP-1α/CCL3, MIP-1β/CCL4, RANTES/CCL5, IFN-γ, IP-10/CXCL10, and MDC/CCL22 were measured by enzyme- linked immunosorbent assay in blood plasma of each person.</p><p><strong>Results: </strong>The following chemokines were included in the list of the most promising diagnostic markers: MCP-1, MIP-1α, MIG, RANTES, and IFN-γ. Their blood plasma content in patients with a diagnosed pathology was from 3 to 60 times (MIG) higher than in the conditionally healthy group. Their sensitivity and specificity exceeded 90%.</p><p><strong>Conclusion: </strong>An increase in their content leads to active monocytes/macrophages migration to the site of inflammation, where they suppress effector T-cell activity by binding suppressor exosomes and activate B-cells by autoantigens presentation received due to joint tissue destruction. This allows us to speak about the predominance of the Th1-mediated immune response during the development of studied disease chronic inflammation.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Potential Bioactive Components of Persea americana for the Treatment of Rheumatoid Arthritis through Network Pharmacology.","authors":"Krishna Swaroop Akey, Esakkimuthukumar M, Saranya R, Chandru M, Sowbarnika S, Sudharsan J, Dhanush V, Thangavelu Prabha, Jubie S","doi":"10.2174/0115733971294872240801113559","DOIUrl":"https://doi.org/10.2174/0115733971294872240801113559","url":null,"abstract":"<p><strong>Introduction: </strong>Rheumatoid arthritis (RA) is a chronic autoimmune disease character-ized by inflammation and joint destruction, leading to significant disability and reduced quality of life. Current treatment options for RA have limitations, highlighting the need for novel therapeu-tic approaches. In this study, we employed network pharmacology methods to identify potential bioactive compounds from Persea Americana (avocado) for the treatment of RA.</p><p><strong>Materials and methods: </strong>We collected information on the phytoconstituents of avocados from the IMPPAT database and used Data Warrior software to filter out 64 plant constituents based on ADMET criteria. Target genes associated with avocado compounds were identified using the Bindingdb web server, resulting in 209 genes from Persea Americana. Protein-protein interaction (PPI) network analysis was performed using Cytoscape software to identify key genes and pro-teins involved in RA. Protein-drug interactions were analyzed, and ten avocado constituents with high binding affinity were identified.</p><p><strong>Results and discussion: </strong>Our network pharmacology analysis revealed that avocado constituents, particularly Luteolin, have the potential to be developed as novel therapeutics for RA. The PPI network analysis identified key genes and proteins associated with RA, providing insights into the molecular mechanisms of the disease. The high binding affinity observed between Luteolin and PTGS2, a protein involved in joint inflammation, suggests its potential effectiveness in mitigating RA-related inflammation.</p><p><strong>Conclusion: </strong>Our study highlights the potential of avocado constituents, particularly Luteolin, as promising therapeutics for the treatment of rheumatoid arthritis (RA). Through network pharma-cology analysis, we identified key target genes and proteins associated with RA, shedding light on the underlying molecular mechanisms of the disease.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Upadacitinib for Axial Spondyloarthritis: A Systematic Review and Meta-Analysis.","authors":"Ahmed Hamdy G Ali, Asmaa Elganady, Mahmoud Diaa Hindawi, Ahella Ismail A Mousa, Hatem Abdelmoneim Eldeeb, Ahmed Ramadan Fatiem, Yulia Skopina","doi":"10.2174/0115733971296457240805064237","DOIUrl":"10.2174/0115733971296457240805064237","url":null,"abstract":"<p><strong>Introduction: </strong>Upadacitinib, a selective JAK1 inhibitor, has demonstrated promising results in the treatment of axial Spondyloarthritis (AxSpA). AxSpA management remains challenging since there is a gap in knowledge regarding the potential effect of upadacitinib in axSpA patients. Exploring novel therapeutic options is crucial. Therefore, we performed this systematic review and meta-analysis to summarize and synthesize results collected from available randomized-- controlled trials (RCTs) about the efficacy and safety of upadacitinib for patients with axSpA.</p><p><strong>Methods: </strong>A systematic literature search of Medline via PubMed, Web of Science, Scopus, EBSCO, and Cochrane Central was conducted in October 2023. Relevant RCTs were selected, and their data were extracted and analyzed using the RevMan 5.4 software. The main outcomes were assessment in Spondylarthritis International Society (ASAS) 20, ASAS40, SPARCC MRI sacroiliac joint, and Bath Ankylosing Spondylitis disease activity index (BASDAI) 50.</p><p><strong>Results: </strong>Three RCTs with a total of 920 participants were included in this study. Upadacitinib showed significant improvement in the ASAS40 response, ASAS20 response, BASDAI50 response, and SPARCC MRI Sacroiliac Joint change from baseline compared to placebo at 14-week duration (RR 2.19, 95% CI (1.79 to 2.68), P < 0.00001), (RR 1.62, 95% CI [1.42 to 1.84), P < 0.00001), (RR 2.16, 95% CI (1.75 to 2.67), P < 0.00001), and (MD -3.32 points, 95% CI (-3.96 to -2.68), P < 0.00001) respectively. However, this efficacy decreased after the 52-week duration in terms of ASAS40 RR 2.19 vs. 1.02, ASAS20 RR 1.62 vs. 0.98, BASDAI 50 RR 2.16 vs. 1.05, and ASAS Partial Remission RR 3.82 vs. 1.07.</p><p><strong>Conclusion: </strong>Upadacitinib 15 mg showed satisfactory and promising efficacy in the treatment of AxSpA, with no difference in safety profile compared to the placebo.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interleukin 18 (-137G/C, -607C/A) Polymorphisms as Genetic Biomarkers of Susceptibility to Systematic Lupus Erythematosus.","authors":"Zahra Rezaieyazdi, Payman Delavar, Houshang Rafatpanah, Rashin Ganjali, Maryam Sahebari, Samira Tabaei, Habibollah Esmaeili, Mandana Khodashahi","doi":"10.2174/0115733971304493240801094652","DOIUrl":"https://doi.org/10.2174/0115733971304493240801094652","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown etiology. Several studies have suggested that interleukin-18 (IL-18) is associated with SLE pathogenesis. The genotype distribution of IL-18 promoter polymorphisms differs among ethnic populations. The present study aimed to investigate the correlation between IL-18 polymorphisms at positions -137 and -607 in patients situated in Northeastern Iran.</p><p><strong>Methods: </strong>This case-control study examined the prevalence of IL-18 -137C/G and -607C/A polymorphic variants among 95 SLE patients referred to the Department of Rheumatology, who were referred to the general clinics of Ghaem Hospital and Imam Reza Hospital in Mashhad, Iran, were included in the study. In addition, 100 healthy individuals were included in the control group. DNA from whole blood was extracted by the salting-out method using a commercial kit (Biogene, US). Allelic and genotypic frequencies of polymorphisms (-137G/C, -607C/A) in the IL-18 promoter gene were analyzed using a polymerase chain reaction (PCR)-based amplification refractory mutation system (ARMS) method.</p><p><strong>Results: </strong>The results of this study demonstrated that the frequency of SLE patients with the homozygous C/C genotype of the IL-18 promoter gene at position -137 was significantly higher than that of the homozygous G/G genotype (P < 0.001) in normal controls. Furthermore, the polymorphism analysis performed illustrated a significant association between (-137G/C) and (-607C/A) polymorphisms in the IL-18 promoter gene and SLE (P < 0.005).</p><p><strong>Conclusion: </strong>These results indicated that the 607A/A and 137C/C polymorphisms are more prevalent in SLE. Further research involving larger sample sizes from various populations is necessary to elucidate the role of these polymorphisms and the distribution of alleles in SLE patients.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rituximab Therapy for Adult Refractory Systemic Lupus Erythematosus with Neurological and/or Psychiatric Presentations: A PRISMACompliant Meta-Analysis","authors":"Mehran Asad Ayoubi, Maryam Moghaddassi, Mehdi Aloosh","doi":"10.2174/0115733971309959240722062141","DOIUrl":"10.2174/0115733971309959240722062141","url":null,"abstract":"<p><strong>Background: </strong>Rituximab (RTX) is used off-label for refractory cases of systemic lupus\u0000erythematosus (SLE) with extrarenal activity, including neurological and/or psychiatric (N/P) presentations. However, evidence from randomized controlled trials is limited.</p><p><strong>Objective: </strong>This study aimed to conduct a pooled analysis of the effectiveness and safety of RTX\u0000therapy for adult refractory SLE with N/P manifestations.</p><p><strong>Methods: </strong>Electronic searches in PubMed, Epistemonikos, and ICTRP databases and statistical\u0000analysis were conducted in May 2023.</p><p><strong>Results: </strong>Electronic searches identified 20 studies (25 reports). A total of 59 patients (53 females;\u000090%) were included, with a mean age of 33.5±10.6 years and a median disease duration of 3.5\u0000years (range, 0.08 to 25.0) who were followed up post-RTX therapy for a median time of 12\u0000months (range, 3.0 to 46.2). The rate of clinical response (partial or major) was 90% (95% CI, 83\u0000to 96) (n = 57 patients). A third of responders relapsed after a median time of 9.5 months (range,\u00003.0 to 33.0). Pooled pre-RTX/post-RTX scores for Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) (n = 13) were 19±15/7±5 and for neurological British Isles Lupus Assessment\u0000Group (BILAG) (n = 29) were A/D (13), A/C (5), B/D (7), B/C (2), and A/A (2). Patients without\u0000mood disorder had a higher chance of clinical response {relative risk (RR) 1.4 (1.03 to 1.48)}. Patients who benefited the most from RTX therapy were those with psychosis (a higher chance of\u0000major clinical response; RR 1.9 (1.02 to 2.34)), without acute confusional state (a lower chance of\u0000relapse; RR 0.08 (0.006 to 0.791)), and with disease duration <3 years (a lower chance of relapse;\u0000RR 0.18 (0.014 to 0.992)). Infection rate during treatment was 33% (7/21).</p><p><strong>Conclusions: </strong>RTX therapy had good effectiveness. The pooled evidence for safety outcomes was\u0000limited and of low certainty.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}