Safety and efficacy of Rituximab in systemic sclerosis: A systematic review and meta-analysis

Int Immunopharmacol. 2020 Jun:83:106389. doi: 10.1016/j.intimp.2020.106389. Epub 2020 Mar 12.

Abstract

Purpose: Rituximab is widely prescribed to treat systemic sclerosis (SSc) by the depletion of pathogenic B cells. Nonetheless, the clinical benefit of Rituximab in SSc remains contentious. This meta-analysis was conducted to systematically evaluate the safety and efficacy profile of Rituximab in SSc patients.

Patients and methods: We performed a systematic online query in PubMed, Cochrane, and Web of Science. The available studies on the use of Rituximab in SSc patients were comprehensively reviewed and investigated.

Results: In total, 14 studies, including 597 participants, were analyzed. Pooled results showed the long-term improvement in the modified Rodnan skin score (mRSS) for skin function (ΔmRSS: 7.00 at 6 months, 9.70 at 12 months, and 10.93 at 24 months), while forced vital capacity (FVC) (ΔFVC: -0.69 at 6 months, -2.62 at 12 months, and -0.67 at 24 months) and diffusing capacity of the lungs for carbon monoxide (DLCO) (ΔDLCO: -2.39 at 6 months, -3.28 at 12 months, and -0.79 at 24 months) for lung function remained stable in SSc patients after Rituximab treatment. The rate of Rituximab-related adverse events was 12% in the pooled results.

Conclusion: The pooled results of this meta-analysis indicated that Rituximab is well tolerated, and it is able to improve cutaneous function and stabilize pulmonary function in SSc patients.

Keywords: Lung fibrosis; Rituximab; SSc; Skin fibrosis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Animals
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Lung / drug effects
  • Lung / physiology*
  • Rituximab / therapeutic use*
  • Scleroderma, Systemic / drug therapy*
  • Skin / drug effects*
  • Skin / pathology

Substances

  • Immunosuppressive Agents
  • Rituximab