Jing Chen1,2, Gang Chen3,4,5, Huilan Sun6,7. 1. The Shengli Clinical Medical College, Fujian Medical University, Fuzhou, 350001, Fujian, China. 2. Department of Ophthalmology, Fujian Provincial Hospital, Fuzhou, 350001, Fujian, China. 3. The Shengli Clinical Medical College, Fujian Medical University, Fuzhou, 350001, Fujian, China. chengangfj@163.com. 4. Department of Endocrinology, Fujian Provincial Hospital, Fuzhou, 350001, Fujian, China. chengangfj@163.com. 5. Fujian Provincial Key Laboratory of Medical Analysis, Fujian Academy of Medical Sciences, Fuzhou, 350001, Fujian, China. chengangfj@163.com. 6. The Shengli Clinical Medical College, Fujian Medical University, Fuzhou, 350001, Fujian, China. billhuang257@163.com. 7. Department of Ophthalmology, Fujian Provincial Hospital, Fuzhou, 350001, Fujian, China. billhuang257@163.com.
Abstract
AIM: The successful treatment of Graves' ophthalmopathy (GO) remains a challenge, while the efficacy of rituximab (RTX) is at present controversial. The aim of this meta-analysis was to investigate the potential impact of intravenous RTX therapy in patients with GO. METHODS: We performed a search in the PubMed, Embase, and Web of Science databases for relevant studies published before July 2020. The primary outcome was the change of clinical activity score (CAS), and secondary outcomes were the change of proptosis and TSH receptor antibodies (TRAb). A meta-analysis was conducted to calculate the standard mean difference (SMD) for these outcomes by using fixed- or random-effect models. RESULTS: Analysis of outcomes in 152 patients collected from 12 published articles was conducted. Compared to baseline value, CAS was significantly decreased at 1, 6, 12, and >12 months after RTX treatment. For proptosis, the results revealed no significant decrease at 1-3, 6, and ≥12 months. Moreover, the pooled analysis employed in this meta-analysis showed no significant difference of TRAb at 1 month, but significant declines were observed at 6 and ≥12 months. CONCLUSION: Our results strongly suggest that intravenous RTX treatment has an acute and long-lasting beneficial effect on decreasing both CAS and TRAb. The study also indicates that the effect of RTX on proptosis is limited. There is evidently a need to investigate the mechanism behind RTX ineffectiveness on proptosis and explore other therapeutic regimens for the reduction of proptosis.
AIM: The successful treatment of Graves' ophthalmopathy (GO) remains a challenge, while the efficacy of rituximab (RTX) is at present controversial. The aim of this meta-analysis was to investigate the potential impact of intravenous RTX therapy in patients with GO. METHODS: We performed a search in the PubMed, Embase, and Web of Science databases for relevant studies published before July 2020. The primary outcome was the change of clinical activity score (CAS), and secondary outcomes were the change of proptosis and TSH receptor antibodies (TRAb). A meta-analysis was conducted to calculate the standard mean difference (SMD) for these outcomes by using fixed- or random-effect models. RESULTS: Analysis of outcomes in 152 patients collected from 12 published articles was conducted. Compared to baseline value, CAS was significantly decreased at 1, 6, 12, and >12 months after RTX treatment. For proptosis, the results revealed no significant decrease at 1-3, 6, and ≥12 months. Moreover, the pooled analysis employed in this meta-analysis showed no significant difference of TRAb at 1 month, but significant declines were observed at 6 and ≥12 months. CONCLUSION: Our results strongly suggest that intravenous RTX treatment has an acute and long-lasting beneficial effect on decreasing both CAS and TRAb. The study also indicates that the effect of RTX on proptosis is limited. There is evidently a need to investigate the mechanism behind RTX ineffectiveness on proptosis and explore other therapeutic regimens for the reduction of proptosis.
Authors: Mark F Prummel; Annemieke Bakker; Wilmar M Wiersinga; Lelio Baldeschi; Maarten P Mourits; Pat Kendall-Taylor; Petros Perros; Chris Neoh; A Jane Dickinson; John H Lazarus; Carol M Lane; Armin E Heufelder; George J Kahaly; Suzanne Pitz; Jacques Orgiazzi; Alain Hullo; Aldo Pinchera; Claudio Marcocci; Maria S Sartini; Roberto Rocchi; Marco Nardi; Gerry E Krassas; A Halkias Journal: Eur J Endocrinol Date: 2003-05 Impact factor: 6.664
Authors: L Bartalena; G E Krassas; W Wiersinga; C Marcocci; M Salvi; C Daumerie; C Bournaud; M Stahl; L Sassi; G Veronesi; C Azzolini; K G Boboridis; M P Mourits; M R Soeters; L Baldeschi; M Nardi; N Currò; A Boschi; M Bernard; G von Arx Journal: J Clin Endocrinol Metab Date: 2012-10-04 Impact factor: 5.958