SynthesisPediatric nephrology (Berlin, Germany)2026
Rituximab in pediatric refractory nephrotic syndrome: a systematic review and meta-analysis evaluating therapeutic efficacy and adverse event profiles.
Synthesis in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Authors and funding
3 authors.
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Abstract
backgroundRituximab is considered a therapeutic option in children with refractory nephrotic syndrome (RNS). However, the efficacy and safety of rituximab treatment remain unclear.
objectiveThis study systematically evaluated the clinical effectiveness and related adverse event profiles of rituximab compared with other immunosuppressants in children with RNS.
methodTwo independent investigators conducted the methodological rigor evaluation in a double-blind manner. Statistical analyses were performed using RevMan 5.4.
resultsRelative to other conventional second-line agents, rituximab therapy presented a significantly increased relapse-free survival rate [vs. tacrolimus: OR = 3.42, 95% CI = 1.96-5.94, P < 0.01]. Fewer adverse drug reactions occurred in patients with rituximab than with other immunosuppressants [vs. cyclophosphamide: OR = 0.18, 95% CI = 0.04-0.89, P = 0.03; vs. tacrolimus: OR = 0.26, 95% CI = 0.07-0.92, P = 0.04]. The application of rituximab increased the steroid-discontinued rate and decreased the corticosteroid dose in the treatment [vs. cyclophosphamide: OR = 5.46, 95% CI = 2.00-14.92, P = 0.0009; vs. tacrolimus: OR = 3.42, 95% CI = 1.67-7.01, P = 0.0008].
conclusionOur study demonstrates rituximab's superior efficacy and safety profile compared to conventional second-line immunosuppressants in pediatric RNS, particularly regarding steroid minimization. Systematic review registration number: CRD420251082051.
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