Papuashvili Papuna, Vepkhishvili Giorgi, Makaridze Tinatin, Popiashvili Giorgi
Internal Medicine, Tbilisi State Medical University, Tbilisi, GEO.
Oncology, Todua Clinic, Tbilisi, GEO.
Cureus. 2024 Aug 14;16(8):e66838. doi: 10.7759/cureus.66838. eCollection 2024 Aug.
This systematic review evaluates the efficacy of rituximab in inducing and maintaining remission in patients with granulomatosis with polyangiitis (GPA). We conducted a comprehensive search across multiple databases, identifying 81 studies, of which 11 met our inclusion criteria after rigorous screening and assessment for relevance and quality. Our analysis shows that rituximab, compared to traditional treatments such as cyclophosphamide and azathioprine, significantly improves remission rates and reduces relapse frequency in GPA patients. Notably, rituximab's benefits extend across various patient demographics, including pediatric groups, and are evident in different dosing regimens, highlighting its versatility and potential as a first-line therapy. The review also underscores the importance of personalized medicine approaches in managing GPA, as rituximab's effectiveness was particularly pronounced in patients with relapsing disease forms. Future research should focus on long-term outcomes, optimal dosing strategies, and the economic implications of widespread rituximab use in clinical practice. Our findings advocate for the integration of rituximab into standard treatment protocols for GPA, offering new hope for patients afflicted with this challenging autoimmune disorder.
本系统评价评估了利妥昔单抗在诱导和维持显微镜下多血管炎（GPA）患者缓解方面的疗效。我们对多个数据库进行了全面检索，共识别出81项研究，经过严格筛选以及对相关性和质量的评估，其中11项符合我们的纳入标准。我们的分析表明，与环磷酰胺和硫唑嘌呤等传统治疗方法相比，利妥昔单抗显著提高了GPA患者的缓解率并降低了复发频率。值得注意的是，利妥昔单抗的益处适用于包括儿科群体在内的各种患者人群，并且在不同的给药方案中均有体现，凸显了其作为一线治疗方法的通用性和潜力。该评价还强调了个性化医疗方法在管理GPA中的重要性，因为利妥昔单抗在复发疾病形式的患者中疗效尤为显著。未来的研究应聚焦于长期结果、最佳给药策略以及在临床实践中广泛使用利妥昔单抗的经济影响。我们的研究结果主张将利妥昔单抗纳入GPA的标准治疗方案，为患有这种具有挑战性的自身免疫性疾病的患者带来了新的希望。
