Alharthi Amal M, Aljundi Ziad, Alharbi Fatimah A, Alfaqih Khadija E
Neurology, King Abdullah Medical City, Mecca, SAU.
Cureus. 2024 Sep 22;16(9):e69936. doi: 10.7759/cureus.69936. eCollection 2024 Sep.
Given the growing popularity of Rituximab (Rmab) treatment as a potential substitute for cyclophosphamide, we conducted this review to determine aspects related to Rmab therapy in central nervous system vasculitis (CNSV) patients, aiming to establish both the beneficial and detrimental consequences of Rmab while providing clinical guidance for managing patients' conditions. This systematic review was prepared following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The PubMed, Web of Science, and Scopus databases were utilized to investigate Rmab treatment in CNSV from January 2015 to May 2024. The research question was structured using the Population, Intervention, Comparison, Outcome, and Study Design (PICOS) criteria. Case series with only three or more unique cases, prospective or retrospective non-randomized studies, and randomized controlled trials (RCTs) were addressed. The initial evaluations were performed in PubMed, Scopus, and Web of Science. After removing duplicate entries, 177 publications were obtained, and 41 were chosen for full-text assessment. The review then incorporated information gathered from 27 studies, including 4 case series, 15 non-randomized cohorts, and 8 RCTs. Rmab is generally regarded as effective for CNSV therapy. Given its success, induction Rmab therapy is now frequently employed as maintenance therapy for CNSV patients. Rmab is a viable option for the induction of remission and maintenance treatment, with a successful reduction in relapse rates.
鉴于利妥昔单抗（Rmab）治疗作为环磷酰胺潜在替代方案的日益普及，我们进行了这项综述，以确定与中枢神经系统血管炎（CNSV）患者Rmab治疗相关的方面，旨在明确Rmab治疗的利弊，同时为患者病情管理提供临床指导。本系统综述是按照系统评价和Meta分析的首选报告项目（PRISMA）指南编写的。利用PubMed、科学网和Scopus数据库调查2015年1月至2024年5月期间CNSV患者的Rmab治疗情况。研究问题采用人群、干预措施、对照、结局和研究设计（PICOS）标准构建。纳入了仅有三个或更多独特病例的病例系列、前瞻性或回顾性非随机研究以及随机对照试验（RCT）。最初在PubMed、Scopus和科学网进行评估。去除重复条目后，获得了177篇出版物，选择了41篇进行全文评估。该综述随后纳入了从27项研究中收集的信息，包括4个病例系列、15个非随机队列和8个RCT。Rmab通常被认为对CNSV治疗有效。鉴于其成功，诱导性Rmab治疗现在经常被用作CNSV患者的维持治疗。Rmab是诱导缓解和维持治疗的可行选择，可成功降低复发率。
