{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:57:00Z","timestamp":1791593820708,"version":"4.3.4"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T00:00:00Z","timestamp":1727222400000},"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. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Rituximab (RTX) is a monoclonal antibody that has been increasingly used in the treatment of myasthenia gravis (MG). In most studies, the therapeutic protocol of RTX has been similar to that adopted for B cell lymphoma, with an increasing number of studies aimed at exploring the efficacy of low-dose RTX in MG. However, the beneficial effects of low-dose RTX in MG remain a subject of critical debate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was conducted following the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Two reviewers (Xishuai Yang and Bingxia Li) independently conducted searches across multiple databases, including PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Library, and China National Knowledge Infrastructure (CNKI). A meta-analysis, utilizing representative forest plots, was performed to assess \u201cImproved clinical status\u201d and changes in the Quantitative Myasthenia Gravis (QMG) score before and after treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 17 studies involving 292 patients were included in the meta-analysis. A noticeable improvement in clinical status was observed in 91% of patients at the final follow-up after therapy (95% CI: 84\u201396%, <jats:italic>P<\/jats:italic> &amp;lt; 0.001). The QMG score showed a significant reduction following the treatment, with a standardized mean difference (SMD) of \u22121.69 (95% CI: \u22122.21 to \u22121.16, <jats:italic>Z<\/jats:italic> = 6.29, <jats:italic>P<\/jats:italic> &amp;lt; 0.001). In the acetylcholine receptor antibody-positive myasthenia gravis (AChR-MG) group, 90% of patients achieved improved clinical status (95% CI: 80\u201397%, <jats:italic>P<\/jats:italic> &amp;lt; 0.001) and the QMG score significantly decreased after low-dose RTX treatment, with an SMD of \u22121.51 (95% CI: \u22120.80 to \u22122.21, <jats:italic>Z<\/jats:italic> = 4.50, <jats:italic>P<\/jats:italic> &amp;lt; 0.001). In the muscle-specific kinase antibody-positive myasthenia gravis (MuSK-MG) group, 97% of patients achieved improved clinical status (95% CI: 89\u2013100%, <jats:italic>P<\/jats:italic> &amp;lt; 0.001). The QMG score also significantly decreased following low-dose RTX treatment, with an SMD of \u22122.31 (95% CI: \u22122.99 to \u22121.62, <jats:italic>Z<\/jats:italic> = 6.60, <jats:italic>P<\/jats:italic> &amp;lt; 0.001). Adverse effects were reported in 29 out of 207 patients (14%, including infusion reactions in 22 patients (10.1%), infections in three patients (1.45%), cytopenia in two patients (0.96%), eosinophilia in one patient (0.48%), and hemiplegia in one patient (0.48%). Additionally, one patient (0.48%) succumbed to complications from invasive thymoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our meta-analysis shows that low-dose RTX is both effective and safe for treating MG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Review Registration<\/jats:title><jats:p>PROSPERO, identifier: CRD42024509951.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2024.1439899","type":"journal-article","created":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T12:37:06Z","timestamp":1727267826000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Efficacy and safety of low-dose rituximab in the treatment of myasthenia gravis: a systemic review and 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