文献类型：期刊文献

英文题名：Effectiveness of rituximab in neuromyelitis optica: a meta-analysis

作者：Gao, Fulin[1,2];Chai, Bingyan[2];Gu, Cheng[1];Wu, Ruipeng[1];Dong, Tong[1];Yao, Yuping[1];Zhang, Yi[1]

第一作者：Gao, Fulin

通信作者：Zhang, Y[1]

机构：[1]Gansu Prov Hosp, Dept Neurol, 204 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China;[2]Gansu Univ Tradit Chinese Med, Sch Clin Med, 35 Dingxi East Rd, Lanzhou 730000, Gansu, Peoples R China

第一机构：Gansu Prov Hosp, Dept Neurol, 204 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China

通信机构：[1]corresponding author), Gansu Prov Hosp, Dept Neurol, 204 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China.

年份：2019

卷号：19

期号：1

外文期刊名：BMC NEUROLOGY

收录：;Scopus(收录号：2-s2.0-85062584657);WOS:【SCI-EXPANDED(收录号:WOS:000460774400001)】；

语种：英文

外文关键词：Neuromyelitis optica; Rituximab; Meta-analysis; Aquaporin-4 autoantibody; Annualized relapse rate; Expanded disability status scale

摘要：BackgroundNeuromyelitis optica (NMO) is a severe inflammatory autoimmune disorder of the central nervous system and often results in paralysis or blindness. Rituximab (RTX) is a mouse-human chimeric monoclonal antibody specific for the CD20 antigen on B lymphocytes and used to treat many autoimmune diseases. Disability and relapses were measured using the Expanded Disability Status Scale (EDSS) and annualized relapse rate (ARR) ratio to evaluate the effectiveness of RTX. This review performed a meta-analysis of the efficacy of RTX in NMO.MethodsWe searched through the databases of PubMed, Embase, and Cochrane Library. We compiled 26 studies, in which 18 used ARR ratio, 22 used EDSS score, and 14 used both variables. Differences in the ARR ratio and EDSS score before and after RTX therapy were used as the main efficacy measures. Publication bias was evaluated after the consistency test, and a sensitivity analysis was performed with mean difference (MD) of the efficacy of RTX.ResultsA meta-analysis of 26 studies with 577 participants was conducted. Antibodies against aquaporin-4 autoantibody were recorded in 435 of 577 (75.39%) patients with NMO. RTX therapy resulted in a mean (WMD) -1.56 (95% CI, -1.82 to -1.29) reduction in the mean ARR ratio and a mean (WMD) -1.16 (95% CI, -1.36 to -0.96) reduction in the mean EDSS score. A total of 330 of 528 patients (62.9%) reached the relapse-free state. A total of 95 of 577 (16.46%) patients had adverse reactions.ConclusionsRTX has acceptable tolerance, reduces the relapse frequency, and improves disability in most patients with NMO. Future studies should focus on reducing the health-care costs, improving the functional outcomes, and reducing the adverse effects associated with RTX treatment.