• Lu You, Peiyi Ye, Guanqing Xiao, Jiabao Liang, and Yaozhong Kong.
• Department of Nephrology, The First People's Hospital of Foshan, Foshan, Guangdong, China.
• Turk J Med Sci. 2021 Dec 13; 51 (6): 287028802870-2880.

Background/AimThis meta-analysis comprehensively investigated the efficacy and safety of rituximab (RTX) in patients with idiopathic membranous nephropathy (IMN).Materials And MethodsWe searched the MEDLINE, EMBASE and Cochrane Registry of Controlled Trials databases from January 2000 to January 2020. Studies evaluating the efficacy and safety of RTX in the treatment of IMN with nephrotic syndrome (NS) were included.ResultsNine studies (total of 357 patients) were included in the meta-analysis. The pooled complete response and overall response (OR) rates at 12 months were 13.2% [95% con fidence interval (CI), 0.09–0.18] and 60% (95% CI, 0.48–0.72), and those at 24 months were 27.8% (95% CI, 0.22–0.34) and 66% (95% CI, 0.6–0.72), respectively. The pooled OR rates for the low-, standard-, and high-dose groups were 39.3%, 64%, and 60%, respectively, and those for the first-line and second-line groups were 58% and 54%, respectively.ConclusionTreatment of IMN with RTX has comparable efficacy to other immunosuppressive treatments (ISTs). RTX has the advantages of no requirement for steroids and lower rates adverse event and relapse rates. Patients who relapse or are resistant to other IST agents also respond to RTX. RTX-based regimens and other B-cell-targeted therapies may represent the future of IMN therapy.This work is licensed under a Creative Commons Attribution 4.0 International License.

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