PMID- 35699520
OWN - NLM
STAT- MEDLINE
DCOM- 20230224
LR  - 20230927
IS  - 1536-7355 (Electronic)
IS  - 1076-1608 (Print)
IS  - 1076-1608 (Linking)
VI  - 29
IP  - 2
DP  - 2023 Mar 1
TI  - Efficacy and Safety of Biologic Agents for Lupus Nephritis: A Systematic Review 
      and Meta-analysis.
PG  - 95-100
LID - 10.1097/RHU.0000000000001877 [doi]
AB  - OBJECTIVES: The aim of this study was to examine the effect and safety of 
      biological agents for lupus nephritis (LN). METHODS: PubMed, EMBASE, and the 
      Cochrane Library databases were searched from their inception up to November 
      2021. The outcomes were overall response, complete remission, proteinuria, renal 
      activity index, and adverse events (AEs). Only randomized controlled trials 
      (RCTs) were included. RESULTS: Nine RCTs (1645 patients) were included. The RCTs 
      evaluated abatacept (n = 2), belimumab (n = 1), obinutuzumab (n = 1), atacicept 
      (n = 1), IL-2 (n = 1), ocrelizumab (n = 1), and rituximab (n = 2). The use of 
      biological agents was associated with higher likelihoods of achieving an overall 
      response (relative risk [RR], 1.26; 95% confidence interval [CI], 1.15-1.39; p < 
      0.001; I2 = 14.3%; pQ = 0.301) and a complete response (RR, 1.33; 95% CI, 
      1.16-1.54; p < 0.001; I2 = 41.8%; pQ = 0.056). The use of biological agents was 
      not associated with improvements in the urinary protein-to-creatinine ratio 
      (weighted mean difference, 3.83; 95% CI, -3.71 to 11.38; p = 0.319; I2 = 99.4%; 
      pQ < 0.001). The use of biological agents in patients with LN was also not 
      associated with an increased risk of any AEs (RR, 1.01; 95% CI, 0.98-1.04; p = 
      0.519; I2 = 0.0%; pQ = 0.533), serious AEs (RR, 0.95; 95% CI, 0.82-1.09; p = 
      0.457; I2 = 0.0%; pQ = 0.667), grade >3 AEs (RR, 0.91; 95% CI, 0.67-1.22; p = 
      0.522; I2 = 0.0%; pQ = 0.977), infections (RR, 1.09; 95% CI, 0.99-1.20; p = 
      0.084; I2 = 0.0%; pQ = 0.430), and deaths (RR, 0.67; 95% CI, 0.36-1.24; p = 
      0.200; I2 = 0.0%; pQ = 0.439). The meta-regression analysis showed that follow-up 
      duration and the sample size did not influence the complete response rate, 
      whereas publications in 2012 to 2014 influence the rate compared with 2015 to 
      2020. CONCLUSIONS: Biological agents seem to be effective and safe for managing 
      patients with LN.
CI  - Copyright (c) 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Chen, Pang
AU  - Chen P
AD  - From the Department of Rheumatology, Mindong Hospital Affiliated to Fujian 
      Medical University, Ningde.
FAU - Zhou, Yadong
AU  - Zhou Y
AD  - Department of Kidney, Blood, and Rheumatology, Affiliated Fuding Hospital, Fujian 
      University of Traditional Chinese Medicine, Fuzhou.
FAU - Wu, Lianghua
AU  - Wu L
AD  - Department of Oncology and Hematology.
FAU - Chen, Shihan
AU  - Chen S
AD  - Department of Rheumatology Integrated of TCM and Western Medicine.
FAU - Han, Fangduo
AU  - Han F
AD  - Department of Respiratory and Critical Care Medicine, Mindong Hospital Affiliated 
      to Fujian Medical University, Ningde, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20220614
PL  - United States
TA  - J Clin Rheumatol
JT  - Journal of clinical rheumatology : practical reports on rheumatic & 
      musculoskeletal diseases
JID - 9518034
RN  - 7D0YB67S97 (Abatacept)
RN  - 4F4X42SYQ6 (Rituximab)
RN  - 0 (Biological Products)
SB  - IM
MH  - Humans
MH  - Abatacept
MH  - *Lupus Nephritis/therapy
MH  - Rituximab
MH  - *Biological Products/therapeutic use
MH  - Randomized Controlled Trials as Topic
PMC - PMC9940827
COIS- The authors declare no conflict of interest.
EDAT- 2022/06/15 06:00
MHDA- 2023/02/25 06:00
PMCR- 2023/02/20
CRDT- 2022/06/14 09:33
PHST- 2022/06/15 06:00 [pubmed]
PHST- 2023/02/25 06:00 [medline]
PHST- 2022/06/14 09:33 [entrez]
PHST- 2023/02/20 00:00 [pmc-release]
AID - 00124743-202303000-00006 [pii]
AID - JCR_220174 [pii]
AID - 10.1097/RHU.0000000000001877 [doi]
PST - ppublish
SO  - J Clin Rheumatol. 2023 Mar 1;29(2):95-100. doi: 10.1097/RHU.0000000000001877. 
      Epub 2022 Jun 14.