Rituximab versus cyclophosphamide in the management of Wegener#39;s granulomatosis: A systematic review and meta-analysis

Abstract

Background : Wegener granulomatosis is an auto- immune disease that causes damage in blood vessels, type of Antineutrophil cytoplasmic antibody (ANCA)- associated vasculitis. The treatment by Rituximab versus Cyclophosphamide that different mechanism on CD20 on B cell and alkylating DNA due to replication dividing cells like neutrophils and lymphocytes. Methods : We systematically searched electronic databases, including PubMed, Scopus, Elsevier and Cochrane journals, spanning from each database's inception to Aug 10, 2024.Following guidelines specifiedin the Preferred Reporting Items for Systematic Reviewsand Meta-Analyses (PRISMA), Pooled effect estimates with 95% confidence intervals will be calculated using random-effects model. Results: Four studies have included in this meta- analysis total 504 patients after events that are evaluatingthe safety and effectiveness of Rituximab compared to Cyclophosphamide in patients with Antineutrophil cytoplasmic antibody (ANCA)- associated vasculitis and two studies focusing on patient with renal diseases. Conclusion : This meta-analysis indicates that Rituximab has a higher mortality rate. On the other hand, Cyclophosphamide shows a higher vasculitis damage score. By Birmingham Vasculitis Activity Score for Wegener’s Granulomatosis there is no significant preference between the two drugs. It is recommended for patients with ANCA to use a different investigation to confirm from a positive result to balance efficacy and minimize harmful consequences.