Wang Yupeng, Chang Haoxiao, Zhang Xinghu, Yin Linlin
Department of Neurology, Beijing Tiantan Hospital, China National Clinical Research Center for Neurological Diseases, Capital Medical University, No.119 South 4(th) Ring West Road, Fengtai District, Beijing 100160, China.
Mult Scler Relat Disord. 2021 May;50:102843. doi: 10.1016/j.msard.2021.102843. Epub 2021 Feb 13.
Neuromyelitis optica spectrum disorders (NMOSD) is an autoimmune astrocyte disease that mainly affects the optic nerve and spinal cord resulting in blindness or paralysis. Rituximab (RTX) is a chimeric monoclonal antibody directed against the surface antigen of CD20 on B lymphocytes and is an emerging treatment option in NMOSD. The present review aimed to conduct an update systematic review and meta-analysis for the efficacy of RTX in the treatment of NMOSD and analyze main factors affecting the efficacy of RTX.
The following Medical Subject Heading (MeSH) and related entry terms are used to search English literature in PubMed, MEDLINE and CENTRAL databases, respectively. MeSH include: Neuromyelitis optic and Rituximab; entry terms include: NMO Spectrum Disorder, NMO Spectrum Disorders, Neuromyelitis Optica (NMO) Spectrum Disorder, Neuromyelitis Optica Spectrum Disorders, Devic Neuromyelitis Optica, Neuromyelitis Optica, Devic, Devic's Disease, Devic Syndrome, Devic's Neuromyelitis Optica, Neuromyelitis Optica (NMO) Spectrum Disorders, CD20 Antibody, Rituximab CD20 Antibody, Mabthera, IDEC-C2B8 Antibody, GP2013, Rituxan; (note: literature retrieval operators "AND" "OR" "NOT" are used to link MeSH with Entry Terms.) 54 studies were included in this systematic review and 29 studies were included in meta-analysis. The main efficacy indicators were the difference of the expanded disability status scale (EDSS) and annualized relapse rate (ARR) between before and after rituximab treatments.
In 29 studies involving 732 patients (643 women, 84 men, 5 with unknown gender), the EDSS and ARR were reduced by an average of -0.57 (95%CI, -0.69 to -0.44), -1.57 (95%CI, -1.78 to -1.35), respectively.
Our systematic review and update meta-analysis provide new evidences that RTX can effectively improve disability and reduce ARR ratio.
视神经脊髓炎谱系障碍（NMOSD）是一种自身免疫性星形胶质细胞疾病，主要影响视神经和脊髓，导致失明或瘫痪。利妥昔单抗（RTX）是一种针对B淋巴细胞表面抗原CD20的嵌合单克隆抗体，是NMOSD中一种新兴的治疗选择。本综述旨在对RTX治疗NMOSD的疗效进行更新的系统评价和荟萃分析，并分析影响RTX疗效的主要因素。
分别使用以下医学主题词（MeSH）和相关入口词在PubMed、MEDLINE和CENTRAL数据库中检索英文文献。MeSH包括：视神经脊髓炎和利妥昔单抗；入口词包括：NMO谱系障碍、NMO谱系疾病、视神经脊髓炎（NMO）谱系障碍、视神经脊髓炎谱系疾病、德维克视神经脊髓炎、视神经脊髓炎、德维克、德维克病、德维克综合征、德维克视神经脊髓炎、视神经脊髓炎（NMO）谱系疾病、CD20抗体、利妥昔单抗CD20抗体、美罗华、IDEC-C2B8抗体、GP2013、利妥昔；（注意：文献检索运算符“AND”“OR”“NOT”用于将MeSH与入口词链接。）本系统评价纳入54项研究，荟萃分析纳入29项研究。主要疗效指标为利妥昔单抗治疗前后扩展残疾状态量表（EDSS）和年化复发率（ARR）的差异。
在涉及732例患者（643例女性、84例男性、5例性别未知）的29项研究中，EDSS和ARR分别平均降低了-0.57（95%CI，-0.69至-0.44）、-1.57（95%CI，-1.78至-1.35）。
我们的系统评价和更新的荟萃分析提供了新的证据，表明RTX可有效改善残疾状况并降低ARR。
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