{"title":"利妥昔单抗治疗结缔组织病相关间质性肺疾病：系统回顾和荟萃分析","authors":"Jiaqi Zhang, Yanjun Wan, Liheng Liu, Yan Tang, Pingping Li, Hui Huang","doi":"10.1093/postmj/qgaf034","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Rituximab (RTX) is utilized for treating connective tissue disease-associated interstitial lung disease (CTD-ILD) by eliminating pathogenic B cells, yet its clinical benefit remains debated. This study evaluates RTX's efficacy and safety in CTD-ILD.</p><p><strong>Methods: </strong>A literature search was conducted in PubMed, Embase, and Cochrane Library for studies on RTX in CTD-ILD up to May 24, 2024. The Joanna Briggs Institute checklist assessed study quality. Changes in forced vital capacity (FVC%) and diffusing capacity of the lungs for carbon monoxide (DLCO%) before and after RTX use were compared, and analyzed between RTX and control groups.</p><p><strong>Results: </strong>1052 CTD-ILD patients from 40 studies were analyzed. RTX significantly improved FVC% (WMD = 7.10, 95% CI = 4.58-9.62, P < 0.05) and DLCO% (WMD = 5.26, 95% CI = 2.86-7.65, P < 0.01), and reduced the modified Rodnan skin score (mRSS) (WMD = -6.58, 95% CI = -8.27 to -4.89, P < 0.01) and prednisone dose (WMD = -6.94, 95% CI = -11.96 to -1.92, P < 0.01). Among RTX-treated patients, 30.3% improved, 45.3% remained stable, and 10.0% progressed. Adverse effects included infection (22.4%), hospitalization (6.7%), and mortality (5.0%).</p><p><strong>Conclusions: </strong>RTX significantly enhances lung function in CTD-ILD patients, as shown in this systematic review and meta-analysis.</p><p><strong>Systematic review registration: </strong>PROSPERO, identifier CRD42024520084.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Rituximab therapy for connective tissue disease-associated interstitial lung disease: a systematic review and meta-analysis.\",\"authors\":\"Jiaqi Zhang, Yanjun Wan, Liheng Liu, Yan Tang, Pingping Li, Hui Huang\",\"doi\":\"10.1093/postmj/qgaf034\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Rituximab (RTX) is utilized for treating connective tissue disease-associated interstitial lung disease (CTD-ILD) by eliminating pathogenic B cells, yet its clinical benefit remains debated. This study evaluates RTX's efficacy and safety in CTD-ILD.</p><p><strong>Methods: </strong>A literature search was conducted in PubMed, Embase, and Cochrane Library for studies on RTX in CTD-ILD up to May 24, 2024. The Joanna Briggs Institute checklist assessed study quality. Changes in forced vital capacity (FVC%) and diffusing capacity of the lungs for carbon monoxide (DLCO%) before and after RTX use were compared, and analyzed between RTX and control groups.</p><p><strong>Results: </strong>1052 CTD-ILD patients from 40 studies were analyzed. RTX significantly improved FVC% (WMD = 7.10, 95% CI = 4.58-9.62, P < 0.05) and DLCO% (WMD = 5.26, 95% CI = 2.86-7.65, P < 0.01), and reduced the modified Rodnan skin score (mRSS) (WMD = -6.58, 95% CI = -8.27 to -4.89, P < 0.01) and prednisone dose (WMD = -6.94, 95% CI = -11.96 to -1.92, P < 0.01). Among RTX-treated patients, 30.3% improved, 45.3% remained stable, and 10.0% progressed. Adverse effects included infection (22.4%), hospitalization (6.7%), and mortality (5.0%).</p><p><strong>Conclusions: </strong>RTX significantly enhances lung function in CTD-ILD patients, as shown in this systematic review and meta-analysis.</p><p><strong>Systematic review registration: </strong>PROSPERO, identifier CRD42024520084.</p>\",\"PeriodicalId\":20374,\"journal\":{\"name\":\"Postgraduate Medical Journal\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2025-03-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Postgraduate Medical Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/postmj/qgaf034\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Postgraduate Medical Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/postmj/qgaf034","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景：利妥昔单抗（RTX）通过消除致病性B细胞用于治疗结缔组织病相关间质性肺疾病（CTD-ILD），但其临床益处仍存在争议。本研究评价RTX治疗CTD-ILD的疗效和安全性。方法：在PubMed、Embase、Cochrane图书馆检索截至2024年5月24日的CTD-ILD中RTX的相关文献。乔安娜布里格斯研究所的检查表评估了研究质量。比较RTX使用前后肺活量（FVC%）和肺一氧化碳弥散量（DLCO%）的变化，并分析RTX与对照组的差异。结果：分析了来自40项研究的1052例CTD-ILD患者。RTX显著提高了FVC% （WMD = 7.10, 95% CI = 4.58 ~ 9.62, P < 0.05）和DLCO% (WMD = 5.26, 95% CI = 2.86 ~ 7.65, P < 0.01)，降低了改良罗南皮肤评分（mRSS） （WMD = -6.58, 95% CI = -8.27 ~ -4.89, P < 0.01）和泼尼松剂量（WMD = -6.94, 95% CI = -11.96 ~ -1.92, P < 0.01）。在接受rtx治疗的患者中，30.3%好转，45.3%保持稳定，10.0%进展。不良反应包括感染（22.4%）、住院（6.7%）和死亡（5.0%）。结论：本系统综述和荟萃分析显示，RTX可显著增强CTD-ILD患者的肺功能。系统评价注册：PROSPERO，标识符CRD42024520084。
Rituximab therapy for connective tissue disease-associated interstitial lung disease: a systematic review and meta-analysis.
Background: Rituximab (RTX) is utilized for treating connective tissue disease-associated interstitial lung disease (CTD-ILD) by eliminating pathogenic B cells, yet its clinical benefit remains debated. This study evaluates RTX's efficacy and safety in CTD-ILD.
Methods: A literature search was conducted in PubMed, Embase, and Cochrane Library for studies on RTX in CTD-ILD up to May 24, 2024. The Joanna Briggs Institute checklist assessed study quality. Changes in forced vital capacity (FVC%) and diffusing capacity of the lungs for carbon monoxide (DLCO%) before and after RTX use were compared, and analyzed between RTX and control groups.
Results: 1052 CTD-ILD patients from 40 studies were analyzed. RTX significantly improved FVC% (WMD = 7.10, 95% CI = 4.58-9.62, P < 0.05) and DLCO% (WMD = 5.26, 95% CI = 2.86-7.65, P < 0.01), and reduced the modified Rodnan skin score (mRSS) (WMD = -6.58, 95% CI = -8.27 to -4.89, P < 0.01) and prednisone dose (WMD = -6.94, 95% CI = -11.96 to -1.92, P < 0.01). Among RTX-treated patients, 30.3% improved, 45.3% remained stable, and 10.0% progressed. Adverse effects included infection (22.4%), hospitalization (6.7%), and mortality (5.0%).
Conclusions: RTX significantly enhances lung function in CTD-ILD patients, as shown in this systematic review and meta-analysis.
期刊介绍：
Postgraduate Medical Journal is a peer reviewed journal published on behalf of the Fellowship of Postgraduate Medicine. The journal aims to support junior doctors and their teachers and contribute to the continuing professional development of all doctors by publishing papers on a wide range of topics relevant to the practicing clinician and teacher. Papers published in PMJ include those that focus on core competencies; that describe current practice and new developments in all branches of medicine; that describe relevance and impact of translational research on clinical practice; that provide background relevant to examinations; and papers on medical education and medical education research. PMJ supports CPD by providing the opportunity for doctors to publish many types of articles including original clinical research; reviews; quality improvement reports; editorials, and correspondence on clinical matters.
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