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Meta-Analysis
. 2018 Feb 17;18(1):46.
doi: 10.1186/s12886-018-0679-4.

Does rituximab improve clinical outcomes of patients with thyroid-associated ophthalmopathy? A systematic review and meta-analysis

Changjun Wang  1 , Qingyao Ning  1 , Kai Jin  1 , Jiajun Xie  1 , Juan Ye  2
Affiliations
Meta-Analysis

Does rituximab improve clinical outcomes of patients with thyroid-associated ophthalmopathy? A systematic review and meta-analysis

Changjun Wang et al. BMC Ophthalmol. .

Abstract

Background: The current therapies of thyroid-associated ophthalmopathy (TAO) were still a challenging matter. In this study, we aimed to contrast the impact of before- after rituximab (RTX) therapy in the patients with TAO.

Methods: We searched the PubMed, EMBASE, and SCOPUS databases for articles published up to July 3, 2017. Fixed- or random-effects meta-analysis was used to provide pooled estimates of standard mean difference (SMD) both the primary outcome from clinical activity score (CAS), and secondary outcomes from thyrotropin receptor antibody (TRAb), proptosis, thyroid stimulating hormone (TSH), and interleukin-6 (IL-6) levels. In addition, the quality and each study was assessed using either the Newcastle Ottawa Scale (NOS) or the Cochrane Risk of Bias tool, and reliability of the meta-analytic result using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).

Results: Of the 839 articles initially searched, 11 studies were finally eligible for inclusion. Subgroup analysis results showed that comparing with initial value, there was a decline in CAS at 1,3,6,12 month after RTX treatment, decreased TRAbs level at 6,12 month, proptosis improvement at least 1 month, unchanged IL-6 level at 6 month, decreased TSH level at 3 month but unchanged at 12 month. All included studies were classified as good quality.

Conclusions: The pooled data suggested that the preliminary effects of RTX treatment on TAO might be promising. However, more large-sample and high-quality studies targeting RTX use during this disease and long-term surveillance of prognosis are urgently needed.

Keywords: Drugs; Eye lids; Inflammation; Orbit; Vision.

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Not applicable.

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Not applicable.

Competing interests

The authors state that there is no competing interests regarding the publication of this paper.

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Figures

Fig. 1
Fig. 1
Study selection
Fig. 2
Fig. 2
Comparing with initial value, there was a decline in CAS at 1 (a) and 3 (b) month after RTX treatment for TAO
Fig. 3
Fig. 3
Comparing with initial value, there was a decline in CAS at 6 (a) and 12 (b) month after RTX treatment for TAO
Fig. 4
Fig. 4
Comparing with initial value, there was a decrease in proptosis at least 1 month after RTX treatment for TAO
Fig. 5
Fig. 5
Comparing with initial value, there was a reduction in TRAbs at 6 (a) and 12 (b) month after RTX treatment for TAO
Fig. 6
Fig. 6
Comparing with initial value, there was a decline in TSH at 3 month (a) but unchangeable at 12 (b) month after RTX treatment for TAO
Fig. 7
Fig. 7
Comparing with initial value, there was unchangeable in IL-6 at 6 month after RTX treatment for TAO
See this image and copyright information in PMC

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