Outcomes of rituximab therapy in refractory lupus: A meta-analysis

Abstract

Objective: Conventional treatment of systemic lupus erythematosus (SLE) and lupus nephritis (LN)is associated with damage accrual, hence increased morbidity rate. Off-label use of rituximab (RTX)has shown significant promise in this patient group; however, data are still controversial. We aimed toanalyze the outcomes of RTX therapy in refractory lupus using a meta-analysis approach.Methods: Electronic search of the medical literature was conducted using a combination of relevantkeywords to retrieve studies on the safety and efficacy of RTX in SLE and LN patients. Results werescreened against our inclusion and exclusion criteria and two reviewers independently extracted thedata for analysis. Comprehensive meta-analysis software was used to pool the data from individualstudies and provide summary effect estimates.Results: Thirty-one studies that enrolled 1112 patients were finally eligible for the meta-analysis. Theoverall global, complete, and partial response rates to RTX therapy were 72%, 46%, and 32%, respective-ly. RTX significantly decreased Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and BritishIsles Lupus Activity Group (BILAG) scores (p