{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:59:23Z","timestamp":1790661563623,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Translational Sci"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Relapsing and refractory lupus nephritis (LN) remains difficult to manage despite advances in immunosuppressive and targeted therapies. Rituximab (RTX) is often used as rescue or add\u2010on therapy, but renal outcomes in this specific setting have not been quantitatively synthesized. PubMed, Embase, and Web of Science were searched from inception to March 30, 2026. Studies of RTX\u2010based therapy in relapsing or refractory LN were included if renal outcomes were reported. Primary outcomes were complete renal response (CRR), partial renal response (PRR), and overall renal response (ORR) at 6, 12, and 24\u2009months; secondary outcomes were changes in proteinuria and serum creatinine. Random\u2010effects models were used. Nineteen studies involving 445 patients were included. Pooled CRR rates were 0.33 (95% CI 0.21\u20130.46), 0.41 (95% CI 0.28\u20130.54), and 0.42 (95% CI 0.26\u20130.60) at 6, 12, and 24\u2009months, respectively. Corresponding PRR rates were 0.29 (95% CI 0.16\u20130.45), 0.23 (95% CI 0.07\u20130.46), and 0.19 (95% CI 0.07\u20130.34), and ORR rates were 0.67 (95% CI 0.52\u20130.80), 0.70 (95% CI 0.51\u20130.86), and 0.66 (95% CI 0.43\u20130.86). Proteinuria decreased by \u22122.69\u2009g\/day\u2010equivalent (95% CI \u22123.23 to \u22122.16), and serum creatinine decreased by \u221211.79\u2009\u03bcmol\/L (95% CI \u221219.86 to \u22123.72). Sensitivity analyses were generally stable, and Egger's test detected no significant publication bias. In conclusion, RTX\u2010based rescue or add\u2010on therapy was associated with moderate renal response rates and reductions in proteinuria and serum creatinine in this difficult\u2010to\u2010treat population. Further prospective comparative studies are needed to define its role.<\/jats:p>","DOI":"10.1111\/cts.70730","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:08:41Z","timestamp":1790658521000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rituximab as Rescue or Add\u2010On Therapy for Relapsing or Refractory Lupus Nephritis: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2745-9508","authenticated-orcid":false,"given":"Xiaolong","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Nephrology, First Medical Center of Chinese PLA General Hospital, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7535-9558","authenticated-orcid":false,"given":"Shuang","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, First Medical Center of Chinese PLA General Hospital, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2665-6741","authenticated-orcid":false,"given":"Xiaowei","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Nephrology, First Medical Center of Chinese PLA General Hospital, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6617-4078","authenticated-orcid":false,"given":"Fuling","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, First Medical Center of Chinese PLA General Hospital, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases  Beijing China"},{"name":"Graduate School of Hebei North University  Zhangjiakou Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0274-0155","authenticated-orcid":false,"given":"Guichun","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, First Medical Center of Chinese PLA General Hospital, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9120-2607","authenticated-orcid":false,"given":"Weizhu","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Nephrology, First Medical Center of Chinese PLA General Hospital, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5251-5294","authenticated-orcid":false,"given":"Meng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nephrology, First Medical Center of Chinese PLA General Hospital, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases  Beijing China"},{"name":"Graduate School of Hebei North University  Zhangjiakou Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8366-6080","authenticated-orcid":false,"given":"Qian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, First Medical Center of Chinese PLA General Hospital, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7426-1666","authenticated-orcid":false,"given":"Zheyi","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Nephrology, First Medical Center of Chinese PLA General Hospital, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.kint.2023.09.001","article-title":"Executive Summary of the KDIGO 2024 Clinical Practice Guideline for the Management of Lupus Nephritis","volume":"105","author":"Rovin B. 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