Department of Neurology, Inner Mongolia People's Hospital No.20 of Zhaowuda Road, Hohhot 010017, Inner Mongolia, People's Republic of China.
Department of Neurology, First Hospital of Shanxi Medical University, No. 85 Jiefangnan Road, Taiyuan 030001, Shanxi, People's Republic of China.
Mult Scler Relat Disord. 2021 Aug;53:103044. doi: 10.1016/j.msard.2021.103044. Epub 2021 May 24.
Myelin oligodendrocyte glycoprotein (MOG) antibody disease (MOG-AD) is now recognised as a nosological entity with specific clinical and paraclinical features to aid early diagnosis. Rituximab (RTX) is a chimeric monoclonal antibody directed against CD20 epitope expressed on pre-B and mature B cells and is used to treat B-cell-derived lymphoid neoplasms and antibody-mediated autoimmune diseases. In this review, we performed a meta-analysis to evaluate RTX efficacy and assessed the treatment efficacies based on relapse rates.
This study was conducted according to the PRISMA (Preferred Reporting Items for Systemic review and Meta-Analysis) statement. We searched for publications on the PubMed, Embase, Cochrane Library, clinical trials up to December 2020. We compiled 5 studies, Meta-analysis forest plots was conducted for the ARR ratio change pre and post-treatment between rituximab and other disease modifying drugs. A sensitivity analysis was performed with mean difference (MD) of the efficacy of RTX versus other immunotherapies and subgroup analysis was also performed based on site of study.
A meta-analysis of 5 studies with 239 participants was conducted. Patients have received rituximab were recorded in 82 of 239 (34.31%). The mean difference of ARR ratio of rituximab therapy versus other immunotherapies was 0.16 (95%CI, -0.15 to 0.47). No studies found to significantly affect heterogeneity. No major differences occurred in 9.2% of China patients (95% CI: -0.20-1.86; I2=0%) and 90.8% of non- China patients (95% CI: -0.24-0.42; I2=0%). Meanwhile there was no significant subgroup difference (p = 0.18) between them.
RTX reduces the relapse frequency in most patients with MOG antibody disease, but there is no differences between rituximab and other immunotherapies in MOG antibody disease. Future a large multicenter randomized controlled clinical trial to thoroughly characterize the efficacy of rituximab for MOG antibody disease is necessary.
髓鞘少突胶质细胞糖蛋白（MOG）抗体病（MOG-AD）现已被确认为一种具有特定临床和辅助检查特征的疾病实体，有助于早期诊断。利妥昔单抗（RTX）是一种嵌合单克隆抗体，针对表达在前 B 和成熟 B 细胞上的 CD20 表位，用于治疗 B 细胞源性淋巴肿瘤和抗体介导的自身免疫性疾病。在本综述中，我们进行了一项荟萃分析，以评估 RTX 的疗效，并根据复发率评估治疗效果。
本研究按照 PRISMA（系统评价和荟萃分析的首选报告项目）声明进行。我们检索了 PubMed、Embase、Cochrane 图书馆和截至 2020 年 12 月的临床试验中的出版物。我们共纳入了 5 项研究，对利妥昔单抗与其他疾病修正药物治疗前后 ARR 比值变化进行了荟萃分析森林图。还进行了敏感性分析，比较了 RTX 与其他免疫疗法的疗效，并根据研究地点进行了亚组分析。
对 5 项研究的 239 名参与者进行了荟萃分析。在 239 名参与者中，有 82 名接受了利妥昔单抗治疗。利妥昔单抗治疗与其他免疫疗法相比，ARR 比值的平均差异为 0.16（95%CI，-0.15 至 0.47）。没有研究发现显著影响异质性。在中国患者中，9.2%（95%CI：-0.20-1.86；I2=0%）和非中国患者中 90.8%（95%CI：-0.24-0.42；I2=0%）的差异无统计学意义。同时，两者之间没有显著的亚组差异（p=0.18）。
RTX 可降低大多数 MOG 抗体病患者的复发频率，但在 MOG 抗体病中，RTX 与其他免疫疗法之间无差异。未来需要进行大型多中心随机对照临床试验，以充分描述 RTX 治疗 MOG 抗体病的疗效。
