Meta-analysis of efficacy and safety of rituximab for children with refractory nephrotic syndrome based on the real world
- VernacularTitle:真实世界中利妥昔单抗治疗儿童难治性肾病综合征的有效性与安全性的Meta分析
- Author:
Xiangge REN
1
,
2
;
Xin YU
1
,
2
;
Jiawei ZHANG
1
,
2
;
Peidong ZHAO
1
,
2
;
Wensheng ZHAI
1
Author Information
1. Pediatric Hospital，the First Affiliated Hospital of Henan University of Chinese Medicine，Zhengzhou 450014，China
2. College of Pediatrics，Henan University of Chinese Medicine，Zhengzhou 450046，China
- Publication Type:Journal Article
- Keywords:
refractory nephrotic syndrome;
frequente-
- From:
China Pharmacy
2024;35(21):2668-2675
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To evaluate the efficacy and safety of rituximab （RTX） in the treatment of children with refractory nephrotic syndrome （RNS） based on the real world by meta-analysis. METHODS A systematic search was conducted on CNKI， Wanfang， VIP， PubMed， Embase， Web of Science， the Cochrane Library， and CINAHL databases to strictly screen the literature and evaluate their quality. A meta-analysis was performed on the extracted literature data using R 4.2.2 and RStudio software. RESULTS A total of 26 real-world studies were included in this study， involving 996 children with steroid-dependent nephrotic syndrome/frequente-relapse nephrotic syndrome （SDNS/FRNS） and 205 children with steroid-resistant nephrotic syndrome （SRNS）. The results of the meta-analysis showed that the complete remission （CR） rate of RTX treatment for RNS was 46% （95%CI： 37%-56%）， the partial remission （PR） rate was 22% （95%CI： 14%-31%）， and the discontinuation rate was 35% （95%CI： 25%-44%）. The results of subgroup analysis showed that the CR rate of RTX treatment in SDNS/FRNS children was 49% （95%CI： 37%-62%）， PR rate was 25% （95%CI： 0-50%）， discontinuation rate was 41% （95%CI： 29%-52%）； the CR rate in SRNS children was 42% （95%CI： 27%-56%）， PR rate was 22%（95%CI： 12%-32%）， discontinuation rate was 21% （95%CI： 4%-38%）. The recurrence rate in children with SDNS/FRNS was 39% （95%CI： 21%-57%） within 1 year or less， 18% （95%CI： 18%-98%） in 2 years and more. As for safety， the majority of adverse reactions were mild infusion reactions， with an incidence of 13% （95%CI： 8%-22%）. Sensitivity analysis suggested that the results were robust. There was publication bias in mild infusion 20210908-BZ-CACM） reaction rate. CONCLUSIONS RTX is effective and safe in the treatment of RNS in children.
