PMID- 33070945
OWN - NLM
STAT- MEDLINE
DCOM- 20211104
LR  - 20220531
IS  - 1578-8989 (Electronic)
IS  - 0025-7753 (Linking)
VI  - 157
IP  - 9
DP  - 2021 Nov 12
TI  - Efficacy and safety of rituximab for childhood refractory nephrotic syndrome: A 
      meta-analysis of randomized controlled trials.
PG  - 418-426
LID - S0025-7753(20)30657-6 [pii]
LID - 10.1016/j.medcli.2020.07.039 [doi]
AB  - BACKGROUND: Idiopathic nephrotic syndrome is the most common glomerular disease 
      in children, but there are still some difficulties in treating childhood 
      steroid-dependent or steroid-resistant nephrotic syndrome (SDNS/SRNS). Rituximab 
      (RTX) might be an effective and safe choice. METHODS: Studies were searched from 
      PubMed, Web of Science, Cochrane library and some Chinese databases up to April 
      2020. Only randomized controlled trials (RCT) were included. RESULTS: Of 1383 
      screened articles, 6 RCTs with 334 participants were included. RTX was better 
      than the control group at improving relapse-free rate in the short term [RR (risk 
      ratio) (95% CI (confidence interval)), 1.84(1.41, 2.39)]. As for long-term, RTX 
      did not show significant improvement [RR (95% CI), 4.43(.57, 34.67)]; but in 
      subgroup analysis, RTX was still better than conventional drugs and tacrolimus 
      [RR (95% CI), 9.91(1.95, 50.52) and 1.42(1.15, 1.75), respectively]. And there 
      was a difference between the two groups of prednisolone dose after treatment [MD 
      (mean difference) (95% CI), -.22(-.36, -.09) mg/kg/d)]. However, RTX did not 
      significantly improve serum albumin and creatinine [MD (95% CI), 3.46(-1.40, 
      8.32)g/L and -3.66(-11.79, 4.48)mumol/L, respectively]. No significant differences 
      between the RTX and the control group were found in total adverse events (AEs) or 
      serious AEs. CONCLUSION: Childhood SDNS/SRNS patients appear to benefit from RTX 
      in relapse-free rate and dose of prednisolone use. Also, RTX did not 
      significantly increase the incidence of AEs. But RTX did not show improvements in 
      biological indicators, more studies are required to explain the effect of RTX.
CI  - Copyright (c) 2020 Elsevier Espana, S.L.U. All rights reserved.
FAU - Chang, Dan
AU  - Chang D
AD  - Department of Nephrology, University of Electronic Science and Technology, 
      Sichuan Academy of Sciences & Sichuan Provincial People's Hospital, Chengdu 
      610072, Sichuan China.
FAU - Gong, Minmin
AU  - Gong M
AD  - Tongji Hospital, Tongji Medical College, Huazhong University of Science and 
      Technology, Wuhan 430030, China.
FAU - Liu, Chaofan
AU  - Liu C
AD  - Tongji Hospital, Tongji Medical College, Huazhong University of Science and 
      Technology, Wuhan 430030, China.
FAU - Zhang, Quan
AU  - Zhang Q
AD  - Tongji Hospital, Tongji Medical College, Huazhong University of Science and 
      Technology, Wuhan 430030, China.
FAU - Hu, Ziwei
AU  - Hu Z
AD  - Tongji Hospital, Tongji Medical College, Huazhong University of Science and 
      Technology, Wuhan 430030, China.
FAU - Li, Zhuoguang
AU  - Li Z
AD  - Department of Endocrinology, Shenzhen Children's Hospital, Shenzhen 518038, 
      China. Electronic address: easonlee2020@163.com.
LA  - eng
LA  - spa
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20201016
PL  - Spain
TA  - Med Clin (Barc)
JT  - Medicina clinica
JID - 0376377
RN  - 0 (Immunosuppressive Agents)
RN  - 4F4X42SYQ6 (Rituximab)
RN  - 9PHQ9Y1OLM (Prednisolone)
SB  - IM
MH  - Child
MH  - Humans
MH  - Immunosuppressive Agents
MH  - *Nephrotic Syndrome/drug therapy
MH  - Prednisolone/therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - Rituximab/adverse effects
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Meta-analysis
OT  - Meta-analisis
OT  - Refractory Nephrotic syndrome
OT  - Rituximab
OT  - Sindrome nefrotico refractario
EDAT- 2020/10/20 06:00
MHDA- 2021/11/05 06:00
CRDT- 2020/10/19 05:28
PHST- 2020/05/26 00:00 [received]
PHST- 2020/07/03 00:00 [revised]
PHST- 2020/07/09 00:00 [accepted]
PHST- 2020/10/20 06:00 [pubmed]
PHST- 2021/11/05 06:00 [medline]
PHST- 2020/10/19 05:28 [entrez]
AID - S0025-7753(20)30657-6 [pii]
AID - 10.1016/j.medcli.2020.07.039 [doi]
PST - ppublish
SO  - Med Clin (Barc). 2021 Nov 12;157(9):418-426. doi: 10.1016/j.medcli.2020.07.039. 
      Epub 2020 Oct 16.