Cochrane · systematic review · CD013874
Rituximab for people with multiple sclerosis
Filippini, G, Kruja, J, Del Giovane, C · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
Multiple Sclerosis and Rare Diseases of the CNSAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
27
current version
GRADE rated
20
No studies
7
Included studies
NR
No studies 7 · 25.9%Ungraded 0 · 0%Very low 8 · 29.6%Low 8 · 29.6%Moderate 4 · 14.8%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Rituximab as 'first choice' versus other disease‐modifying treatments for relapsing multiple sclerosis – results from non‐randomised studies of intervention
Population: relapsing multiple sclerosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Comparison intervention Rituximab as 'first choice' vs other disease‐modifying treatments | no estimate extracted | NR | No studies |
— Rituximab as 'first choice' vs other disease‐modifying treatments | no estimate extracted | NR | No studies |
Interferon beta or glatiramer acetate Rituximab as 'first choice' vs other disease‐modifying treatments | HR 0.14 [0.05, 0.39] | 335 participants | Moderate |
Dimethyl fumarate Rituximab as 'first choice' vs other disease‐modifying treatments | HR 0.29 [0.08, 1] | 206 participants | Low Downgraded: imprecision |
Natalizumab Rituximab as 'first choice' vs other disease‐modifying treatments | HR 0.24 [0.06, 1] | 170 participants | Low Downgraded: imprecision |
Fingolimod Rituximab as 'first choice' vs other disease‐modifying treatments | HR 0.26 [0.04, 1.69] | 137 participants | Very low |
Rituximab as 'first choice' versus placebo for progressive multiple sclerosis – results from randomised controlled trials
Population: primary progressive multiple sclerosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disability worsening measured by EDSS over 24 months Rituximab as 'first choice' vs placebo | OR 0.71 [0.45, 1.11] | 1 study · 439 participants | Moderate Downgraded: risk of bias |
Relapse measured by clinical assessment over 24 months Rituximab as 'first choice' vs placebo | OR 0.6 [0.18, 1.99] | 1 study · 439 participants | Low Downgraded: risk of bias |
Serious adverse events measured by clinical assessment over 28 months Rituximab as 'first choice' vs placebo | OR 1.25 [0.71, 2.2] | 1 study · 439 participants | Low Downgraded: risk of bias |
Quality of life Rituximab as 'first choice' vs placebo | no estimate extracted | NR | No studies |
Common infections measured by clinical assessment over 28 months Rituximab as 'first choice' vs placebo | OR 1.14 [0.75, 1.73] | 1 study · 439 participants | Low |
Cancer measured by clinical assessment over 28 months Rituximab as 'first choice' vs placebo | OR 0.5 [0.07, 3.59] | 1 study · 439 participants | Low |
Mortality measured by clinical assessment over 28 months Rituximab as 'first choice' vs placebo | OR 0.25 [0.02, 2.77] | 1 study · 439 participants | Low |
Rituximab as 'switching' versus placebo for relapsing multiple sclerosis – results from randomised controlled trials
Population: relapsing multiple sclerosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disability worsening Rituximab as 'switching' vs placebo | no estimate extracted | NR | No studies |
Relapse measured by clinical assessment over 12 months Rituximab as 'switching' vs placebo | OR 0.38 [0.16, 0.93] | 1 study · 104 participants | Low Downgraded: risk of bias, imprecision |
Serious adverse events measured by clinical assessment over 12 months Rituximab as 'switching' vs placebo | OR 0.9 [0.28, 2.92] | 1 study · 104 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life Rituximab as 'switching' vs placebo | no estimate extracted | NR | No studies |
Common infections measured by clinical assessment over 12 months Rituximab as 'switching' vs placebo | OR 0.91 [0.37, 2.24] | 1 study · 104 participants | Very low Downgraded: risk of bias, imprecision |
Cancer measured by clinical assessment over 12 months Rituximab as 'switching' vs placebo | OR 1.55 [0.06, 39.15] | 1 study · 104 participants | Very low Downgraded: risk of bias, imprecision |
Mortality measured by clinical assessment over 12 months Rituximab as 'switching' vs placebo | OR 1.55 [0.06, 39.15] | 1 study · 104 participants | Very low Downgraded: risk of bias, imprecision |
Rituximab as 'switching' versus other disease‐modifying treatments for relapsing multiple sclerosis – results from non‐randomised studies of intervention
Population: relapsing multiple sclerosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Comparison intervention Rituximab as 'switching' vs other disease‐modifying treatments | no estimate extracted | NR | No studies |
Interferons or glatiramer acetate Rituximab as 'switching' vs other disease‐modifying treatments | HR 0.86 [0.52, 1.42] | 853 participants | Very low Downgraded: imprecision |
Fingolimod Rituximab as 'switching' vs other disease‐modifying treatments | HR 0.08 [0.02, 0.32] | 256 participants | Moderate |
Natalizumab Rituximab as 'switching' vs other disease‐modifying treatments | HR 1 [0.2, 5] | 153 participants | Very low Downgraded: imprecision |
— Rituximab as 'switching' vs other disease‐modifying treatments | no estimate extracted | NR | No studies |
Interferon beta or glatiramer acetate Rituximab as 'switching' vs other disease‐modifying treatments | OR 1.71 [1.11, 2.62] | 5477 participants | Moderate |
Ocrelizumab Rituximab as 'switching' vs other disease‐modifying treatments | OR 0.02 [0, 0.4] | 472 participants | Very low Downgraded: risk of bias, imprecision |