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Meta-Analysis
. 2015 Feb 3:5:8219.
doi: 10.1038/srep08219.

The efficacy and safety of rituximab in treating childhood refractory nephrotic syndrome: a meta-analysis

Zhihong Zhao  1 , Guixiang Liao  2 , Yongqiang Li  1 , Shulu Zhou  1 , Hequn Zou  1
Affiliations
Meta-Analysis

The efficacy and safety of rituximab in treating childhood refractory nephrotic syndrome: a meta-analysis

Zhihong Zhao et al. Sci Rep. .

Abstract

Rituximab is considered to be a promising drug for treating childhood refractory nephrotic syndrome. However, the efficacy and safety of rituximab in treating childhood refractory nephrotic syndrome remain inconclusive. This meta-analysis aimed to investigate the efficacy and safety of rituximab treatment compared with other immunosuppressive agents in children with refractory nephrotic syndrome. Three randomized controlled trials and two comparative control studies were included in our analysis. The included studies were of moderately high quality. Compared with other immunotherapies, rituximab therapy significantly improved relapse-free survival (hazard ratio = 0.49, 95% confidence interval [CI], 0.26-0.92, P = 0.03). Rituximab also achieved a higher rate of complete remission (risk ratio,1.62; 95% CI, 0.92 to 2.84, P = 0.09) and reduced the occurrence of proteinuria (mean difference = -0.25, 95% CI = -0.29 to -0.21, P < 0.00001); however, a more targeted rituximab treatment did not significantly increase serum albumin levels and did not significantly reduce adverse events. Rituximab might be a promising treatment for childhood refractory nephrotic syndrome; however, the long-term effects and cost-effectiveness of rituximab treatment were not fully assessed, and there were limited studies that evaluated the clinical benefits of a concurrent infusion of rituximab plus a steroid compared with an infusion of rituximab only. Additional studies are required to address these issues.

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Figures

Figure 1
Figure 1. Flow chart of study selection.
Figure 2
Figure 2. Forest plot showing a meta-analysis for riruximab treatment group versus control treatment group on relapse-free survival.
Figure 3
Figure 3. Forest plot showing a meta-analysis for riruximab treatment group versus control treatment group on complete remission rate.
Figure 4
Figure 4. Forest plot showing a meta-analysis for riruximab treatment group versus control treatment group on A. serum albumin; B. serum creatinine; C. proteinuria.
See this image and copyright information in PMC

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