利妥昔单抗治疗复发缓解型多发性硬化症的疗效和安全性：系统评价和荟萃分析。
Efficacy and safety of rituximab for relapsing-remitting multiple sclerosis: A systematic review and meta-analysis.
机构信息
Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Department of Neurology, Mayo Clinic, Rochester, MN 55905, United States.
出版信息
Autoimmun Rev. 2019 May;18(5):542-548. doi: 10.1016/j.autrev.2019.03.011. Epub 2019 Mar 4.
OBJECTIVE
To evaluate the efficacy and safety of rituximab for relapsing-remitting multiple sclerosis.
RESULTS
Fifteen studies that collectively included 946 patients were selected for the meta-analysis. Rituximab therapy was associated with the mean annualized relapse rates decreasing by 0.80 (95% confidence interval, 0.45-1.15) and the mean Expanded Disability Status Scale score decreasing by 0.46 (95% confidence interval, 0.05-0.87). The likelihood of patients experiencing a relapse after starting rituximab therapy was only 15% (95% confidence interval, 7%-26%). Although mild-to-moderate adverse events occurred in 29.6% of the patients, there were no severe adverse events.
CONCLUSIONS AND RELEVANCE
This systematic review and meta-analysis shows that rituximab is associated with reduced annualized relapse rates and disability levels in patients with relapsing-remitting multiple sclerosis. It is also well tolerated and is not associated with serious adverse events.
目的
评估利妥昔单抗治疗复发缓解型多发性硬化症的疗效和安全性。
结果
共纳入 15 项研究，总计 946 例患者，对其进行荟萃分析。利妥昔单抗治疗可使年复发率降低 0.80（95%置信区间，0.45-1.15），扩展残疾状况量表评分降低 0.46（95%置信区间，0.05-0.87）。开始利妥昔单抗治疗后患者复发的可能性仅为 15%（95%置信区间，7%-26%）。尽管 29.6%的患者发生了轻至中度不良反应，但无严重不良反应。
结论和相关性
本系统评价和荟萃分析表明，利妥昔单抗可降低复发缓解型多发性硬化症患者的年复发率和残疾水平，且具有良好的耐受性，不伴有严重不良反应。
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