ReviewCureus2026
Bruton Tyrosine Kinase Inhibitor-Based Therapy Versus Rituximab-Containing Regimens for Chronic Lymphocytic Leukemia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Bruton tyrosine kinase (BTK) inhibitors have increasingly replaced rituximab-based chemoimmunotherapy in chronic lymphocytic leukemia (CLL), but the magnitude of benefit across treatment settings and whether it extends to overall survival remains uncertain. Therefore, we compared BTK inhibitor-based therapy with rituximab-containing regimens in randomized controlled trials (RCTs). PubMed/MEDLINE and the Cochrane Central Register of Controlled Trials were searched from inception to August 2, 2026, for RCTs enrolling adults with CLL or small lymphocytic lymphoma that compared a BTK inhibitor-based strategy with a rituximab-containing comparator and reported progression-free survival (PFS), overall survival (OS), or overall response rate (ORR). Two reviewers independently screened records, extracted data, and assessed risk of bias using RoB 2. Hazard ratios (HRs) were pooled using the generic inverse-variance method and risk ratios (RRs) using the Mantel-Haenszel method, both under random-effects models; heterogeneity was quantified using I². The review followed PRISMA 2020. Eight RCTs comprising 2,781 participants were included, spanning treatment-naive, relapsed or refractory, and covalent BTK inhibitor-pretreated disease. Five trials were at low overall risk of bias, and three raised some concerns. BTK inhibitor-based therapy was associated with significantly longer PFS (eight trials; pooled HR, 0.42; 95% confidence interval (CI): 0.24-0.73; P=0.002), with substantial heterogeneity (I²=93%). Overall response occurred in 440 of 543 patients (81.0%) receiving BTK inhibitor-based therapy versus 350 of 491 (71.3%) receiving rituximab-containing regimens, a nonsignificant difference (four trials; RR: 1.18; 95% CI: 0.98-1.42; P=0.08; I²=86%). OS favored BTK inhibitor-based therapy without reaching statistical significance (six trials; HR: 0.67; 95% CI: 0.40-1.11; P=0.12; I²=48%). Publication bias could not be formally assessed because fewer than 10 trials contributed to any outcome. BTK inhibitor-based therapy was associated with significantly longer PFS compared with rituximab-containing regimens, whereas the evidence for OS and ORR remained inconclusive. Very high heterogeneity indicates that the pooled PFS estimate represents an average across clinically distinct treatment questions rather than a uniform class effect, and treatment selection should remain individualized.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.