PMID- 36044828
OWN - NLM
STAT- MEDLINE
DCOM- 20221214
LR  - 20221221
IS  - 2211-0356 (Electronic)
IS  - 2211-0348 (Linking)
VI  - 68
DP  - 2022 Dec
TI  - Different doses of Rituximab for the therapy of Neuromyelitis optica spectrum 
      disorder: A systematic review and meta-analysis.
PG  - 104127
LID - S2211-0348(22)00634-4 [pii]
LID - 10.1016/j.msard.2022.104127 [doi]
AB  - BACKGROUND: Neuromyelitis optica spectrum disease(NMOSD) is an autoimmune 
      neurological disease that primarily affects the spinal cord, optic nerve, and 
      periventricular organs. Rituximab plays an important role in the prevention of 
      relapse in NMOSD. In this study, we evaluated the efficacy and safety of 
      different doses of the anti-monoclonal antibody rituximab in NMOSD. OBJECTS: Our 
      study aimed to implement a meta-analysis to systematically assess the efficacy 
      and safety of different doses of rituximab in the treatment of NMOSD. METHODS: We 
      searched Pubmed, Embase, the Cochrane Library, and Clinicaltrials.gov for 
      relevant studies evaluating rituximab for NMOSD up to March 2022. Data were 
      assessed using Review Manager 5.3 and Stata 14 softwares. Means and standard 
      deviations(SD) were analyzed using random effects models with continuous 
      outcomes. Risk radio was analyzed using random effects models with dichotomous 
      outcomes. RESULTS: We collected 576 patients from 17 studies. The endpoint of 
      efficacy was the change in annual recurrence rate(ARR), expanded disability 
      status scale (EDSS), and the number of patients free of relapse between 
      pre-treatment and post-treatment of rituximab. We found that rituximab reduced 
      ARR and EDSS, with a significant reduction in ARR(MD= -1.79, 95% CI: -3.18  approximately  
      -0.39, P= 0.01) and EDSS(MD= -1.35, 95% CI: -1.5  approximately  -1.19, P < 0.00001) at 100 mg 
      intravenous infusion per week for 3 consecutive weeks, meanwhile making the 
      number of patients free of relapse increased (RR= 24.61 [5.11, 118.55], P<0.0001) 
      and being relatively safe and without serious adverse events(SAEs). In terms of 
      safety, we compared and summarised the adverse events(AEs) and SAEs from 17 
      studies. CONCLUSION: In this study, we found rituximab to be relatively safe and 
      efficacious in the treatment of NMOSD, particularly at a dose of 100mg 
      intravenous infusion per week for 3 consecutive weeks.
CI  - Copyright (c) 2022 Elsevier B.V. All rights reserved.
FAU - Wei, Kenhui
AU  - Wei K
AD  - Department of Neurology, The First Affiliated Hospital of Soochow University, 
      Suzhou, China; Department of Neurology, Wuxi No. 2 People's Hospital of Nanjing 
      Medical University, Wuxi, Jiangsu Province, China; Institute of Stroke Research, 
      Soochow University, Suzhou, China.
FAU - Nie, Qianqian
AU  - Nie Q
AD  - Department of Neurology, The First Affiliated Hospital of Soochow University, 
      Suzhou, China; Institute of Stroke Research, Soochow University, Suzhou, China.
FAU - Zhu, Yunfei
AU  - Zhu Y
AD  - Department of Neurology, The First Affiliated Hospital of Soochow University, 
      Suzhou, China; Institute of Stroke Research, Soochow University, Suzhou, China.
FAU - Lu, Haifeng
AU  - Lu H
AD  - Department of Neurology, The First Affiliated Hospital of Soochow University, 
      Suzhou, China; Institute of Stroke Research, Soochow University, Suzhou, China. 
      Electronic address: lu.haifeng110@163.com.
FAU - Xue, Qun
AU  - Xue Q
AD  - Department of Neurology, The First Affiliated Hospital of Soochow University, 
      Suzhou, China; Institute of Stroke Research, Soochow University, Suzhou, China. 
      Electronic address: qxue_sz@163.com.
FAU - Chen, Gang
AU  - Chen G
AD  - Institute of Stroke Research, Soochow University, Suzhou, China; Department of 
      Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated 
      Hospital of Soochow University, Suzhou, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20220818
PL  - Netherlands
TA  - Mult Scler Relat Disord
JT  - Multiple sclerosis and related disorders
JID - 101580247
RN  - 4F4X42SYQ6 (Rituximab)
RN  - 0 (Immunologic Factors)
SB  - IM
MH  - Humans
MH  - *Neuromyelitis Optica/therapy
MH  - Rituximab/adverse effects
MH  - Immunologic Factors/adverse effects
MH  - Recurrence
MH  - Infusions, Intravenous
OTO - NOTNLM
OT  - Dose regimens
OT  - Meta-analysis
OT  - NMOSD
OT  - Rituximab
COIS- Declaration of Competing Interest The authors have no conflicts of interest to 
      declare.
EDAT- 2022/09/01 06:00
MHDA- 2022/12/15 06:00
CRDT- 2022/08/31 18:18
PHST- 2022/05/18 00:00 [received]
PHST- 2022/07/27 00:00 [revised]
PHST- 2022/08/16 00:00 [accepted]
PHST- 2022/09/01 06:00 [pubmed]
PHST- 2022/12/15 06:00 [medline]
PHST- 2022/08/31 18:18 [entrez]
AID - S2211-0348(22)00634-4 [pii]
AID - 10.1016/j.msard.2022.104127 [doi]
PST - ppublish
SO  - Mult Scler Relat Disord. 2022 Dec;68:104127. doi: 10.1016/j.msard.2022.104127. 
      Epub 2022 Aug 18.