SYSTEMATIC REVIEW article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1591366
Meta-analysis of the efficacy of Rituximab in the Management of Cryoglobulinemic Vasculitis
Provisionally accepted
- West China Hospital, Sichuan University, Chengdu, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
A primary goal of this study was to systematically assess the efficacy of rituximab (RTX) in treating cryoglobulinemic vasculitis (CV). A prospectively registered meta-analysis was conducted to examine eligible randomized controlled trials (RCTs) or cohort studies through searches across PubMed, Embase, Cochrane Library, and Web of Science, with a search period up to February 12 , 2025. Data analysis was conducted utilizing STATA 16.0. Incorporating data from 12 studies involving 287 patients, CV patients who received RTX therapy demonstrated notable complete clinical response outcomes (Rate=0.67, 95% confidence interval (95%CI): 0.61, 0.73) and a good clinical response rate. In addition, patients showed significant relief in symptoms such as skin purpura and skin ulcer (Rate=0.92, 95%CI: 0.86,0.98). The meta-analysis findings indicated a notable enhancement in serum C4 levels in CV patients following treatment (mean difference (MD)=0.06, 95%CI: 0.04, 0.07), both at 6-month (MD=0.07, 95%CI: 0.05, 0.09) and 12-month (MD=0.07, 95%CI: 0.03, 0.11) follow-ups. These findings suggest a gradual improvement in the underlying condition. The levels of IgM were significantly reduced following treatment (MD=-0.48, 95%CI: -0.65, -0.31), both at 6-month (MD=-1.05, 95%CI: -1.57, -0.52) and 12-month (MD=-0.59, 95%CI:-0.80, - 0.38) follow-ups. The levels of cryoglobulin were also decreased following treatment (MD=-0.53, 95%CI: -0.80, -0.26), both at 6-month (MD=-0.67, 95%CI: -0.99, -0.35) and 12-month (MD=-0.67, 95%CI: -1.15, -0.19) follow-ups. Similarly, rheumatoid factor (RF) levels significantly decreased after treatment (MD=-318.20,95%CI:- 364.66,-271.73) and remained low at the 6-month follow-up (MD=-287.78, 95%CI:- 511.58,-63.97). The meta-analysis supports the favorable clinical efficacy of rituximab in the management of CV patients. However, further validation through additional high-quality RCTs is warranted to solidify its effectiveness.
Keywords: rituximab, Cryoglobulinemic vasculitis, Vasculitis Meta-analysis, clinical efficacy, Anti-CD20
Received: 14 Mar 2025; Accepted: 14 Aug 2025.
Copyright: © 2025 Zhou, Dong, Deng, Wang, Fu, Peng and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jian Zhang, West China Hospital, Sichuan University, Chengdu, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.