Safety and Efficacy of Rituximab in Systemic Sclerosis: A Systematic Review and Meta-analysis

Abstract Background: Rituximab has been widely proposed to treat systemic sclerosis (SSc) by depletion of pathogenic B cells. Nonetheless, the clinical benefit of Rituximab in SSc remains contentious. Objective: This meta-analysis was conducted to systematically evaluate the safety and efficacy profile of Rituximab in SSc patients. Methods: We performed a systematic online query in PubMed, Cochrane, and Web of science. Available studies about the assessment of Rituximab in SSc patients were comprehensively reviewed and investigated. Results: In total, 14 studies comprising 597 participants were enrolled in our analysis. Pooled results showed the durable improvement of mRSS for skin involvement (∆mRSS: 7.00 at 6-month, 9.70 at 12-month, and 10.93 at 24-month), while FVC (∆FVC: -0.69 at 6-month, -2.62 at 12-month, -0.67 at 24-month) and DLCO (∆DLCO -2.39 at 6-month, -3.28 at 12-month, -0.79 at 24-month) for lung involvement remain stable in SSc patients after Rituximab treatment. And safety profile of Rituximab-related adverse events rate was 12% in the pooled result. Conclusion: The pooled results of this meta-analysis indicated that Rituximab was well-tolerated, and it was able to generate improvement of cutaneous function and stabilization of pulmonary function in SSc patients.