Comparative efficacy between rituximab versus conventional therapy and
different dosage of rituximab in idiopathic membranous nephropathy
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.