PMID- 34950240
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220705
IS  - 1756-2856 (Print)
IS  - 1756-2864 (Electronic)
IS  - 1756-2856 (Linking)
VI  - 14
DP  - 2021
TI  - Adverse events of rituximab in neuromyelitis optica spectrum disorder: a 
      systematic review and meta-analysis.
PG  - 17562864211056710
LID - 10.1177/17562864211056710 [doi]
LID - 17562864211056710
AB  - BACKGROUND: The adverse events (AEs) of rituximab (RTX) for neuromyelitis optica 
      spectrum disorder (NMOSD) are incompletely understood. AIM: To collate 
      information on the reported the AEs of RTX in NMOSD and assess the quality of 
      evidence. METHODS: PubMed, EMBASE, Web of Science, Cochrane Library, Wanfang 
      Data, CBM, CNKI, VIP, clinicaltrials.gov, and so on were searched for studies 
      with control groups as well as for case series that had assessed the 
      RTX-associated AEs. The incidence of AEs and the comparison of AE risks among 
      different therapies were pooled. The GRADE was developed for evidence quality. 
      RESULTS: A total of 3566 records were identified. Finally, 36 studies (4 RCTs, 6 
      crochet studies, 2 NRCTs, and 24 case series), including 1542 patients (1299 
      females and 139 males), were included for final analyses. Rates of patients with 
      any AEs, any serious AEs (SAEs), infusion-related AEs, any infection, respiratory 
      infection, urinary infection, and death were 28.57%, 5.66%, 27.01%, 17.36%, 
      4.76%, 4.76%, and 0.17%, respectively. The results from subgroup analysis showed 
      that AE rates were most likely not associated with covariates such as duration of 
      illness and study designs. Very low-quality evidence suggested that the risk 
      ratios (RR) of any AEs (0.84, 95% CI = 00.42-1.69, p = 0.62) and any infections 
      (1.24 95% CI = 0.18-8.61) of RTX were similar to that of azathioprine, and the RR 
      of any AEs of RXT was akin to that of mycophenolate mofetil (0.66, 95% CI = 
      0.32-1.35 p = 0.26). Evidence of low to high quality showed the lower RR of RTX 
      in other AEs, but not in infusion-related AEs. Strategies to handle AEs focused 
      on symptomatic treatments. CONCLUSIONS: RTX is mostly safer than other 
      immunosuppressants in NMOSD: the incidence of RTX-associated AEs was not high, 
      and when present, the AEs were usually mild or moderate and could be well 
      controlled. Given its efficacy and safety, RTX could be recommended as a 
      first-line treatment for NMOSD.
CI  - (c) The Author(s), 2021.
FAU - Wang, Hao
AU  - Wang H
AUID- ORCID: 0000-0002-1015-9141
AD  - Ophthalmology Department, The Second Hospital, Lanzhou University, Lanzhou, 
      China.
FAU - Zhou, Juanping
AU  - Zhou J
AD  - Ophthalmology Department, The Second Hospital, Lanzhou University, Lanzhou, 
      China.
FAU - Li, Yi
AU  - Li Y
AD  - Ophthalmology Department, The Second Hospital, Lanzhou University, Lanzhou, 
      China.
FAU - Wei, Lili
AU  - Wei L
AD  - Evidence-Based Medicine Center, Lanzhou University, Lanzhou, China.
FAU - Xu, Xintong
AU  - Xu X
AD  - Ophthalmology Division, 3rd Medical Center, Chinese PLA General Hospital, 
      Beijing, China.
FAU - Zhang, Jianping
AU  - Zhang J
AD  - Ophthalmology Department, The Second Hospital, Lanzhou University, Lanzhou, 
      China.
FAU - Yang, Kehu
AU  - Yang K
AD  - Evidence-Based Medicine Center, Lanzhou University, Lanzhou, China.
FAU - Wei, Shihui
AU  - Wei S
AUID- ORCID: 0000-0003-2910-0446
AD  - Department of Ophthalmology, the Third Medical Center of PLA General Hospital, 
      Beijing 100853 China.
FAU - Zhang, Wenfang
AU  - Zhang W
AD  - Ophthalmology Department, The Second Hospital, Lanzhou University, Lanzhou 
      730000, China.
LA  - eng
PT  - Journal Article
DEP - 20211217
PL  - England
TA  - Ther Adv Neurol Disord
JT  - Therapeutic advances in neurological disorders
JID - 101480242
EIN - Ther Adv Neurol Disord. 2022 Jun 26;15:17562864221100917. PMID: 35785403
PMC - PMC8689613
OTO - NOTNLM
OT  - adverse events (AEs)
OT  - meta-analysis
OT  - neuromyelitis optica spectrum disorder (NMOSD)
OT  - rituximab (RTX)
OT  - systematic review
COIS- Conflict of interest statement: The authors declared no potential conflicts of 
      interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2021/12/25 06:00
MHDA- 2021/12/25 06:01
PMCR- 2021/12/17
CRDT- 2021/12/24 05:48
PHST- 2021/06/26 00:00 [received]
PHST- 2021/10/10 00:00 [accepted]
PHST- 2021/12/24 05:48 [entrez]
PHST- 2021/12/25 06:00 [pubmed]
PHST- 2021/12/25 06:01 [medline]
PHST- 2021/12/17 00:00 [pmc-release]
AID - 10.1177_17562864211056710 [pii]
AID - 10.1177/17562864211056710 [doi]
PST - epublish
SO  - Ther Adv Neurol Disord. 2021 Dec 17;14:17562864211056710. doi: 
      10.1177/17562864211056710. eCollection 2021.