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Comparative efficacy between rituximab versus conventional therapy and different dosage of rituximab in idiopathic membranous nephropathy
  • Miaomiao Chen,
  • Gaosi Xu,
  • Xuexin Chen
Miaomiao Chen
Nanchang University Second Affiliated Hospital
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Gaosi Xu
Nanchang University Second Affiliated Hospital
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Xuexin Chen
Nanchang University Second Affiliated Hospital
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Abstract

Abstract Objective: This study was to evaluate the efficacy of rituximab (RTX) versus conventional agents and different RTX dose regimens in the treatment of idiopathic membranous nephropathy (IMN). Methods: After systematically searched associated studies up to 1st December 2020, we performed a fixed and random-effects meta-analysis using the Stata software and evaluated the quality of included studies by the risk of bias scale of the Cochrane collaboration tool. Results: RTX had a higher total remission (TR) (OR = 2.663, 95% CI 1.361 to 5.210, P = 0.004) than conventional therapy for patients at moderate risk for lose of kidney function (pre-study proteinuria < 8 g/d), however, for patients at severe risk (pre-study proteinuria > 8 g/d), there was no significant difference in TR (OR = 0.691, 95% CI 0.064 to 7.423, P = 0.761). In RTX dose studies, standard dose regimen had a better effect of reducing proteinuria than low-dose regimen (Low dose MD = -3.999, 95% CI -6.177 to -1.820; standard dose MD = -5.220, 95% CI -7.160 to -3.279, P < 0.0001). Significant improvement in serum albumin was seen in patients treated with standard dose than low dose regimen (Low dose MD = 0.601, 95% CI 0.052 to 1.150, P = 0.032; standard dose MD = 0.963, 95% CI 0.740 to 1.185, P < 0.0001). Conclusion: For patients with moderate risk IMN, RTX treatment has a higher TR than conventional therapy. Standard dose RTX is more effective than low dose in reducing proteinuria and recovering serum albumin levels.