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\n(RTX) versus conventional agents and different RTX dose regimens in the\ntreatment of idiopathic membranous nephropathy (IMN). Methods: After\nsystematically searched associated studies up to 1st December 2020, we\nperformed a fixed and random-effects meta-analysis using the Stata\nsoftware and evaluated the quality of included studies by the risk of\nbias scale of the Cochrane collaboration tool. Results: RTX had a higher\ntotal remission (TR) (OR = 2.663, 95% CI 1.361 to 5.210, P = 0.004)\nthan conventional therapy for patients at moderate risk for lose of\nkidney function (pre-study proteinuria < 8 g/d), however, for\npatients at severe risk (pre-study proteinuria > 8 g/d),\nthere was no significant difference in TR (OR = 0.691, 95% CI 0.064 to\n7.423, P = 0.761). In RTX dose studies, standard dose regimen had a\nbetter effect of reducing proteinuria than low-dose regimen (Low dose MD\n= -3.999, 95% CI -6.177 to -1.820; standard dose MD = -5.220, 95% CI\n-7.160 to -3.279, P < 0.0001). Significant improvement in\nserum albumin was seen in patients treated with standard dose than low\ndose regimen (Low dose MD = 0.601, 95% CI 0.052 to 1.150, P = 0.032;\nstandard dose MD = 0.963, 95% CI 0.740 to 1.185, P < 0.0001).\nConclusion: For patients with moderate risk IMN, RTX treatment has a\nhigher TR than conventional therapy. Standard dose RTX is more effective\nthan low dose in reducing proteinuria and recovering serum albumin\nlevels.