title: The efficacy and safety of rituximab in treating childhood refractory nephrotic syndrome: a meta-analysis.
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.
authors: Department of Nephrology, Institution of Urology and Nephrology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China.
authors: Zhihong
authors: Z
authors: Zhao
authors: Departments of Radiation Oncology, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China.
authors: Guixiang
authors: G
authors: Liao
authors: Department of Nephrology, Institution of Urology and Nephrology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China.
authors: Yongqiang
authors: Y
authors: Li
authors: Department of Nephrology, Institution of Urology and Nephrology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China.
authors: Shulu
authors: S
authors: Zhou
authors: Department of Nephrology, Institution of Urology and Nephrology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China.
authors: Hequn
authors: H
authors: Zou
mesh_terms: D000293:Adolescent; D002648:Child; D002986:Clinical Trials as Topic; D003404:Creatinine / Q000097:blood; D016208:Databases, Factual; D018572:Disease-Free Survival; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D009404:Nephrotic Syndrome / Q000188:drug therapy* / Q000401:mortality; D000069283:Rituximab / Q000627:therapeutic use*; D012709:Serum Albumin / Q000032:analysis; D016896:Treatment Outcome
chemical_list: D007155:Immunologic Factors; D012709:Serum Albumin; D000069283:Rituximab; D003404:Creatinine
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