{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:54:01Z","timestamp":1791820441775,"version":"4.3.4"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To methodically assess the effectiveness and safety of rituximab in treating primary Sj\u00f6gren\u2019s syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The search included databases such as PubMed, Embase, the Cochrane Library, and Web of Science, covering the period from the beginning until December 2023. A meta-analysis was conducted using Stata 14.0 software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five randomized controlled trials (RCTs) with a total of 340 patients were incorporated. The meta-analysis revealed that the group treated with rituximab had significantly lower scores in ESSPRI, pain VAS, serum IgG levels and The blood B cell level was significantly reduced, demonstrating superior results compared to the control group. However, the treatment did not effectively reduce the ESSDAI score, stimulated and unstimulated salivary flow rates and Schirmer\u2019s test results. However, it did lead to a reduction in RF levels and enhanced complement C4 were not statistically different from the values in the control group. The occurrence of adverse events, such as infection, did not show a statistically significant difference between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Research has demonstrated that rituximab can decrease the levels of serum IgG and serum B cells in individuals with Sj\u00f6gren\u2019s syndrome. Additionally, it can significantly enhance the ESSPRI score and pain VAS score in patients. However, it does not have a notable impact on glandular function. The occurrence of adverse effects was like that of the control group. Given the scarcity of research, the findings may be influenced by bias, and a substantial quantity of rigorous investigations is required to validate them.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2025.1561214","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T05:22:02Z","timestamp":1750742522000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Meta-analysis of the efficacy and safety of rituximab in the treatment of primary Sj\u00f6gren\u2019s syndrome"],"prefix":"10.3389","volume":"16","author":[{"given":"Xiao","family":"Zheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaoyang","family":"Di","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuexiao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yixuan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoran","family":"Ning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guimin","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1177\/1759720x17746319","article-title":"Management of primary Sj\u00f6gren\u2019s syndrome: recent developments and new classification criteria","volume":"10","author":"Del Papa","year":"2018","journal-title":"Ther Adv Musculoskelet Dis"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1702514","article-title":"Primary sj\u00f6gren\u2019s syndrome","volume":"378","author":"Mariette","year":"2018","journal-title":"N Engl J Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kez027","article-title":"Pain and fatigue in primary Sj\u00f6gren\u2019s syndrome","volume":"60","author":"Omdal","year":"2021","journal-title":"Rheumatol (Oxford)"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/ico.0000000000001227","article-title":"Comparison of tear osmolarity in rheumatoid arthritis patients with and without secondary sjogren syndrome","volume":"36","author":"Ng","year":"2017","journal-title":"Cornea"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9072299","article-title":"Current state of knowledge on primary sj\u00f6gren\u2019s syndrome, an autoimmune exocrinopathy","volume":"9","author":"Parisis","year":"2020","journal-title":"J Clin Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/5928232","article-title":"Advances in pathogenesis of sj\u00f6gren\u2019s syndrome","volume":"2021","author":"Tian","year":"2021","journal-title":"J Immunol Res"},{"key":"B7","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1038\/s41584-023-00932-6","article-title":"Genetics and epigenetics of primary Sj\u00f6gren syndrome: implications for future therapies","volume":"19","author":"Thorlacius","year":"2023","journal-title":"Nat Rev Rheumatol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s13075-024-03262-4","article-title":"Manifestations and management of Sj\u00f6gren\u2019s disease","volume":"26","author":"Maleki-Fischbach","year":"2024","journal-title":"Arthritis Res Ther"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.0803588","article-title":"Ectopic germinal centers are rare in Sjogren\u2019s syndrome salivary glands and do not exclude autoreactive B cells","volume":"182","author":"Le Pottier","year":"2009","journal-title":"J Immunol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1007\/s10875-005-4091-5","article-title":"Association between circulating levels of the novel TNF family members APRIL and BAFF and lymphoid organization in primary Sj\u00f6gren\u2019s syndrome","volume":"25","author":"Jonsson","year":"2005","journal-title":"J Clin Immunol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.19842.1","article-title":"Recent advances in the search for a targeted immunomodulatory therapy for primary Sj\u00f6gren\u2019s syndrome","volume":"8","author":"Leverenz","year":"2019","journal-title":"F1000Res"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1117699","article-title":"Biological therapy in systemic lupus erythematosus, antiphospholipid syndrome, and Sj\u00f6gren\u2019s syndrome: evidence- and practice-based guidance","volume":"14","author":"Marinho","year":"2023","journal-title":"Front Immunol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1080\/10582450802479693","article-title":"Improved health-related quality of life for patients with active rheumatoid arthritis receiving rituximab: Results of the Dose-Ranging Assessment: International Clinical Evaluation of Rituximab in Rheumatoid Arthritis (DANCER) Trial","volume":"35","author":"Mease","year":"2008","journal-title":"J Rheumatol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1002\/art.11109","article-title":"Improvement in Sj\u00f6gren\u2019s syndrome following therapy with rituximab for marginal zone lymphoma","volume":"49","author":"Somer","year":"2003","journal-title":"Arthritis Rheum"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1002\/art.27314","article-title":"Effectiveness of rituximab treatment in primary Sj\u00f6gren\u2019s syndrome: a randomized, double-blind, placebo-controlled trial","volume":"62","author":"Meijer","year":"2010","journal-title":"Arthritis Rheum"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.083865","article-title":"Reduction of fatigue in Sj\u00f6gren syndrome with rituximab: results of a randomised, double-blind, placebo-controlled pilot study","volume":"67","author":"Dass","year":"2008","journal-title":"Ann Rheum Dis"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1002\/art.40093","article-title":"Randomized controlled trial of rituximab and cost-effectiveness analysis in treating fatigue and oral dryness in primary sj\u00f6gren\u2019s syndrome","volume":"69","author":"Bowman","year":"2017","journal-title":"Arthritis Rheumatol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2535","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"339","author":"Moher","year":"2009","journal-title":"BMJ"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.163030","article-title":"A randomized, phase II study of sequential belimumab and rituximab in primary Sj\u00f6gren\u2019s syndrome","volume":"7","author":"Mariette","year":"2022","journal-title":"JCI Insight"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.7326\/l14-5017-4","article-title":"Treatment of primary Sj\u00f6gren syndrome with rituximab. In response","volume":"161","author":"Saraux","year":"2014","journal-title":"Ann Intern Med"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.7326\/m13-1085","article-title":"Treatment of primary Sj\u00f6gren syndrome with rituximab: a randomized trial","volume":"160","author":"Devauchelle-Pensec","year":"2014","journal-title":"Ann Intern Med"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2018.1","article-title":"B cells in the pathogenesis of primary Sj\u00f6gren syndrome","volume":"14","author":"Nocturne","year":"2018","journal-title":"Nat Rev Rheumatol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1136\/annrheumdis-2019-216114","article-title":"EULAR recommendations for the management of Sj\u00f6gren\u2019s syndrome with topical and systemic therapies","volume":"79","author":"Ramos-Casals","year":"2020","journal-title":"Ann Rheum Dis"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e0150749","DOI":"10.1371\/journal.pone.0150749","article-title":"Rituximab effectiveness and safety for treating primary sj\u00f6gren\u2019s syndrome (pSS): systematic review and meta-analysis","volume":"11","author":"Souza","year":"2016","journal-title":"PloS One"},{"key":"B25","doi-asserted-by":"publisher","first-page":"76","DOI":"10.26442\/terarkh201890576-80","article-title":"The efficacy of rituximab in the therapy of neuromyelitis optica in a patient with Sjogren\u2019s syndrome: case-report and literature review","volume":"90","author":"Torgashina","year":"2018","journal-title":"Ter Arkh"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e58288","DOI":"10.7759\/cureus.58288","article-title":"Rituximab in childhood and juvenile pemphigus vulgaris: A systematic review","volume":"16","author":"Shrivastava","year":"2024","journal-title":"Cureus"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1561214\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T05:22:03Z","timestamp":1750742523000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1561214\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,24]]},"references-count":26,"alternative-id":["10.3389\/fimmu.2025.1561214"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2025.1561214","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,24]]},"article-number":"1561214"}}