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Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
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Rituximab treatment for lupus nephritis: A systematic review

Zijie Yuan1, Qifang Xie2, Xiaochuan Wu3

  • 1Pediatric Medical Center, Hunan Provincial People's Hospital (The first-affiliated hospital of Hunan normal university), Changsha, China.

Clinical and Investigative Medicine. Medecine Clinique Et Experimentale
|June 29, 2020
PubMed

Insights

Rituximab shows higher complete remission rates for lupus nephritis compared to cyclophosphamide. However, its effectiveness and safety are similar to cyclophosphamide and mycophenolate mofetil in treating this condition.

Area of Science:

  • Nephrology
  • Immunology
  • Pharmacology

Background:

  • Lupus nephritis is a severe complication of systemic lupus erythematosus.
  • Treatment options for lupus nephritis aim to induce remission and prevent kidney damage.
  • Rituximab is an immunomodulatory drug used in autoimmune diseases.

Purpose of the Study:

  • To systematically review the effectiveness and safety of rituximab in treating lupus nephritis.
  • To compare rituximab with other standard treatments like cyclophosphamide and mycophenolate mofetil.

Main Methods:

  • A Cochrane systematic review was conducted.
  • Searched multiple databases (Cochrane, MEDLINE, EMBASE, etc.) up to February 2016.
  • Analyzed five randomized controlled trials (RCTs) involving 238 patients, evaluating remission rates, urinary protein, disease activity, and adverse events.

Main Results:

  • Rituximab demonstrated a significantly higher complete remission rate compared to cyclophosphamide (OR=2.80, P=0.03).
  • No significant differences were observed in partial or total remission rates between rituximab and cyclophosphamide.
  • Effectiveness and safety profiles were similar when comparing rituximab to mycophenolate mofetil and combination therapy.

Conclusions:

  • Rituximab is more effective in achieving complete remission for lupus nephritis than cyclophosphamide.
  • Rituximab offers comparable effectiveness and safety to cyclophosphamide and mycophenolate mofetil for lupus nephritis treatment.
Abstract

Keywords:
rituximabcyclophosphamidelupus nephritissystematic reviewmeta-analysis

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