PMID- 36378118
OWN - NLM
STAT- MEDLINE
DCOM- 20230201
LR  - 20230202
IS  - 1756-185X (Electronic)
IS  - 1756-1841 (Linking)
VI  - 26
IP  - 2
DP  - 2023 Feb
TI  - Rituximab for connective tissue disease-associated interstitial lung disease: A 
      systematic review and meta-analysis.
PG  - 225-235
LID - 10.1111/1756-185X.14495 [doi]
AB  - OBJECTIVE: To assess the efficacy of rituximab (RTX) on lung function and the 
      prevalence of adverse events (AEs) in connective tissue disease-associated 
      interstitial lung disease (CTD-ILD) by meta-analysis. METHODS: EMBASE, Web of 
      Science, PubMed and ClinicalKey were searched up to July 16, 2021. The lung 
      function (forced vital capacity, FVC% predicted, and diffusing capacity of the 
      lung for carbon monoxide, DLCO% predicted) and prevalence of AEs of RTX in 
      CTD-ILD were analyzed by meta-analysis, and 95% confidence interval (CI) was 
      calculated. Subgroup analyses and meta-regression were used to explore the 
      heterogeneity. RESULTS: We identified 29 studies, including 827 CTD-ILD patients 
      with a median age of 53.05 years. In observational studies, FVC% (mean 
      difference - 1.24, 95% CI [-2.35, -0.12]; P = .030) and DLCO% (-7.71, [-11.79, 
      -3.63]; P = .014) of CTD-ILD decreased significantly after RTX treatment. In 
      randomized controlled trials, FVC% of CTD-ILD decreased after RTX treatment 
      (-5.24, [-9.94, - 0.54]; P = .029), but the difference of DLCO% was not 
      significant (1.15, [-4.33, 6.63]; P = .681). The prevalence of AEs, all-cause 
      mortality and infections was 29.7% (95% CI [0.17, 0.42]), 11.6% (95% CI [0.08, 
      0.16]) and 20.9% (95% CI [0.15, 0.27]), respectively. CONCLUSIONS: RTX was 
      associated with AEs such as decreased pulmonary function, all-cause mortality, 
      and infections in CTD-ILD. Adverse reactions during and after RTX treatment 
      should be carefully monitored. Further prospective studies are needed to compare 
      RTX with other immunosuppressants, antifibrotic drugs or placebos, which can 
      provide therapeutic approaches for CTD-ILD.
CI  - (c) 2022 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons 
      Australia, Ltd.
FAU - Wang, Yilin
AU  - Wang Y
AUID- ORCID: 0000-0002-1691-1621
AD  - School of Medicine and Nursing, Huzhou University, Huzhou, China.
FAU - Li, Liren
AU  - Li L
AUID- ORCID: 0000-0002-0817-8327
AD  - School of Medicine, Nantong University, Nantong, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20221115
PL  - England
TA  - Int J Rheum Dis
JT  - International journal of rheumatic diseases
JID - 101474930
RN  - 4F4X42SYQ6 (Rituximab)
SB  - IM
MH  - Humans
MH  - Middle Aged
MH  - *Connective Tissue Diseases/complications/diagnosis/drug therapy
MH  - Lung
MH  - *Lung Diseases, Interstitial/diagnosis/drug therapy/epidemiology
MH  - Retrospective Studies
MH  - Rituximab/adverse effects
OTO - NOTNLM
OT  - adverse effects
OT  - connective tissue disease
OT  - interstitial lung disease
OT  - pulmonary function
OT  - rituximab
EDAT- 2022/11/16 06:00
MHDA- 2023/01/31 06:00
CRDT- 2022/11/15 10:23
PHST- 2022/07/21 00:00 [revised]
PHST- 2022/03/21 00:00 [received]
PHST- 2022/10/17 00:00 [accepted]
PHST- 2022/11/16 06:00 [pubmed]
PHST- 2023/01/31 06:00 [medline]
PHST- 2022/11/15 10:23 [entrez]
AID - 10.1111/1756-185X.14495 [doi]
PST - ppublish
SO  - Int J Rheum Dis. 2023 Feb;26(2):225-235. doi: 10.1111/1756-185X.14495. Epub 2022 
      Nov 15.