Abid Naushad, Manaye Sara, Naushad Hamzah, Cheran Kaaviya, Murthy Chinmayee, Bornemann Elisa A, Kamma Hari Krishna, Alabbas Mohammad, Elashahab Mohammed
Internal Medicine, King Faisal University College of Medicine, Al-Ahsa, SAU.
Internal Medicine / Rheumatology, King Faisal University, Al-Ahsa, SAU.
Cureus. 2023 Jun 21;15(6):e40719. doi: 10.7759/cureus.40719. eCollection 2023 Jun.
There is a vital role of B cells in the pathogenesis of Systemic Lupus Erythematosus (SLE). Belimumab (Bel), an inhibitor of B cell activating factor (BAFF), and Rituximab (RTX), a monoclonal antibody targeting Cd20 antigen, have been used to manage systemic lupus. Several randomized controlled trials (RCTs) have evaluated these two agents' clinical efficacy and safety in different manifestations of SLE. This study aims to review the randomized control trials involving these two agents systematically and to explain if any disparity is noticed in the primary and secondary outcomes between these two agents. This study is done according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After applying the inclusion criteria and quality assessment by independent reviewers and co-authors, relevant papers were identified, and data were extracted. The results have shown that RCTs involving Belimumab achieved primary endpoints; however, targeted endpoints were not achieved in studies involving Rituximab. It is concluded that despite the conflicting results obtained in clinical trials, both are effective in systemic lupus, as indicated in real-world clinical experience. However, better-designed multicenter studies evaluating these B-cell-targeting drugs are needed.
B细胞在系统性红斑狼疮（SLE）的发病机制中起着至关重要的作用。贝利尤单抗（Bel）是一种B细胞活化因子（BAFF）抑制剂，而利妥昔单抗（RTX）是一种靶向Cd20抗原的单克隆抗体，它们已被用于治疗系统性红斑狼疮。多项随机对照试验（RCT）评估了这两种药物在SLE不同表现中的临床疗效和安全性。本研究旨在系统回顾涉及这两种药物的随机对照试验，并解释这两种药物在主要和次要结局方面是否存在差异。本研究是根据系统评价和Meta分析的首选报告项目（PRISMA）指南进行的。在由独立评审人员和共同作者应用纳入标准和质量评估后，确定了相关论文并提取了数据。结果表明，涉及贝利尤单抗的随机对照试验达到了主要终点；然而，涉及利妥昔单抗的研究未达到目标终点。得出的结论是，尽管临床试验结果相互矛盾，但如实际临床经验所示，这两种药物对系统性红斑狼疮均有效。然而，需要设计更完善的多中心研究来评估这些靶向B细胞的药物。
