A meta-analysis of the efficacy of rituximab in the treatment of refractory nephrotic syndrome

Objective To systematically evaluate the efficacy of rituximab in the treatment of refractory nephrotic syndrome by meta-analysis.Methods This study searched the databases of PubMed,EMBASE,Cochrane Library,CNKI,WanFang and VIP to collect the clinical randomized controlled trials of rituximab in the treatment of refractory nephrotic syndrome.And the retrieval time was from the establishment of the database to January 2020.After the inclusion and exclusion criteria were jointly formulated by two evaluators,the literature was screened independently and the quality evaluated.Review Manager 5.3 software was utilized for meta-analysis.Results A total of 7 studies involving 409 subjects were retrieved.The results of meta-analysis showed that rituximab elevating serum albuminSMD=0.80,95%CI(0.27,1.34),P<0.05 was superior to control group and the remission rateRR=1.68,95%CI(1.16,2.42),P<0.05 was better than control group.As compared with control group,there was no significant effect on relieving urinary proteinSMD=-0.71,95%CI(-1.45,0.03),P>0.05,serum creatinineSMD=0.18,95%CI(-0.20,0.56),P>0.05 or eGFRSMD=0.05,95%CI(-0.72,0.82),P>0.05.Conclusions Rituximab can effectively alleviate refractory nephrotic syndrome and elevate serum albumin.However,due to limited inclusion studies,the above conclusions should be verified by more high-quality studies.