Rituximab for the management of idiopathic membranous nephropathy: a meta-analysis
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NEPHROLOGY - ORIGINAL PAPER
Rituximab for the management of idiopathic membranous nephropathy: a meta‑analysis Lan Huang1 · Qiao‑Rong Dong1 · Ya‑Juan Zhao1 · Gui‑Cai Hu1 Received: 26 May 2020 / Accepted: 31 August 2020 © Springer Nature B.V. 2020
Abstract Purpose The aim of this study was to evaluate the efficacy of rituximab therapy in the management of idiopathic membranous nephropathy (IMN). Methods After literature search, data from eligible studies were used to perform random-effects meta-analyses to estimate remission rates and changes in proteinuria at the latest follow-up after rituximab therapy. The outcomes were used for metaregression to identify the factors affecting the efficacy of rituximab. Results Twenty-one studies were included in the analysis (602 patients; age 50 years [95% CI 46.8, 53.3]; 30% females [95% CI 23, 31]). Follow-up duration was 20.3 months [95% CI 17.1, 23.5]. Remission rate (67% [95% CI 61, 73]) was higher in studies with below average baseline proteinuria (76% [95% CI 61, 88]) than in studies with above average baseline proteinuria (61% [95% CI 54, 68]). The complete and partial remission rates were 26% [95% CI 20, 33] and 37% [95% CI 31, 43], respectively. Rituximab therapy significantly reduced proteinuria (mean difference between final and baseline values: − 4.90 g/day [95% CI − 6.18, − 3.63]; p
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