title: [Is rituximab effective for induction of remission in lupus nephritis?].
abstract: The combination of cyclophosphamide and steroids constitutes the standard treatment in lupus nephritis requiring immunosuppressive therapy. However, it is associated with important adverse effects, so there is interest in alternative immunosuppressors such as rituximab. Searching in Epistemonikos database, which is maintained by screening 19 databases, we identified 5 systematic reviews including 24 studies. We combined the evidence using summary of findings tables following the GRADE approach and concluded there is uncertainty about the effects of rituximab in lupus nephritis because the certainty of the evidence is very low, probably leads to important adverse effects, and has high cost. Rituximab should not be used outside the context of a clinical trial, or only in cases where other treatments have failed and there are no resource constraints.
authors.affiliation: Programa de Salud Basada en Evidencia, Facultad de Medicina, Pontificia Universidad Católica de Chile; Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile. Address: Facultad de Medicina, Pontificia Universidad Católica de Chile, Lira 63, Santiago Centro, Chile. Email: radagabriel@epistemonikos.org.
authors.forename: Macarena
authors.initials: M
authors.lastname: Mac-Namara
authors.affiliation: Programa de Salud Basada en Evidencia, Facultad de Medicina, Pontificia Universidad Católica de Chile; Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile; GRADE working group; The Cochrane Collaboration; Fundación Epistemonikos.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Rada
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D016527:Drug Costs; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D008181:Lupus Nephritis / Q000188:drug therapy* / Q000503:physiopathology; D012074:Remission Induction; D000069283:Rituximab; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab