ArticleInternational urology and nephrology2025
Rituximab, tacrolimus, cyclophosphamide and cyclosporin in primary membranous nephropathy with nephrotic syndrome: comparison of safety profiles, effect on remission rate, 24-h urinary total protein, serum albumin, and serum creatinine levels using network meta-analysis.
Article in International urology and nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Artificial intelligence in membranous nephropathy: transforming clinical management toward precision medicine.Frontiers in medicine · 2026Review
- Short-term clinical remission rates and adverse reactions of rituximab compared to cyclosporine in patients with refractory membranous nephropathy (MN).American journal of translational research · 2026Article
- Model-Informed Precision Dosing of Tacrolimus Initial Dosage Optimization in Membranous Nephropathy Patients.Drug design, development and therapy · 2026Article
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Authors and funding
6 authors.
Funding
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Abstract
objectiveTo compare the efficacy and safety of four immunosuppressive therapies, either alone or in combination, for primary membranous nephropathy through a network meta-analysis.
methodsA literature search was conducted for randomized controlled trials (RCTs) of Cyclophosphamide (CTX), Cyclosporin (CsA), Tacrolimus (TAC), and Rituximab (RIT) in the treatment of primary membranous nephropathy. Two researchers independently screened articles, extracted data, and evaluated the quality. Outcome indicators included dichotomous variables and continuous variables, which were represented by risk ratios (RR) and mean differences (MD), respectively. Then, various interventions were ranked according to the surface under the cumulative ranking curve (SUCRA).
resultsA total of 21 randomized controlled trials (RCTs) were included, encompassing 1396 patients. In terms of the overall response rate (ORR), RIT+TAC was superior to CsA (RR = 0.15, 95% CI: 0.04, 0.54), CTX (RR = 0.09, 95% CI: 0.03, 0.31), and RIT (RR = 7.06, 95% CI: 2.29, 21.80). The SUCRA value of RIT+TAC was the highest, reaching 93.5%. Regarding the total 24-h urinary protein (24UTP), RIT+TAC was better than RIT (MD = 17.05, 95% CI: 6.49, 44.79), RIT+CTX (MD = 6.99, 95% CI: 2.55, 19.17), TAC (MD = 0.12, 95% CI: 0.07, 0.18), CsA (MD = 0.06, 95% CI: 0.00, 0.86), and CTX (MD = 0.05, 95% CI: 0.03, 0.10). The SUCRA value of RIT+TAC was the highest, at 99.4%. For serum albumin, RIT+CTX was superior to CTX (MD = 0.00, 95% CI: 0.00, 0.29), and the SUCRA value of RIT+CTX was the highest, at 76.7%. For serum creatinine (Scr), RIT+TAC was better than TAC (MD = 0.00, 95% CI: 0.00, 0.13), and CsA was better than TAC (MD = 7.86e+07, 95% CI: 3.65e+06, 1.69e+09). The SUCRA value of RIT+TAC was the highest, at 79.9%. In terms of the incidence of adverse reactions, CTX had a higher rate than RIT+CTX (RR = 11.12, 95% CI: 1.34, 92.15). The SUCRA value of RIT+CTX was the lowest, at 5.3%.
conclusionIn terms of improving ORR, reducing 24UTP and lowering Scr, the RIT+TAC regimen may be the most optimal. Conversely, RIT+CTX demonstrated the best efficacy in improving ALB and also exhibited relatively better safety profile.
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