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Nephro Pharmacology

Efficacy and safety of rituximab in patients with lupus nephritis: A systematic review and meta-analysis 

Zhiming Tang, Yanqin Huang, Yuqian Lin, Rong Wang, Yuming Huang, Haiting Huang, Qiuhong Zhong, and Xu Lin

###ENGLISH_ABSTRACT_LINK### ###FREE_ENGLISH_ARTICLE_DOWNLIAD_LINK###

Volume 103 (2025) p. 53 - 62

Abstract

Clinical Nephrology, Vol. 103 – No. 1/2025 (53-62)

Efficacy and safety of rituximab in patients with lupus nephritis: A systematic review and meta-analysis 

Zhiming Tang¹#²*, Yanqin Huang¹#²*, Yuqian Lin¹#²*, Rong Wang¹#², Yuming Huang¹#², Haiting Huang¹#², Qiuhong Zhong³, and Xu Lin¹#²

¹Department of Nephrology, Affiliated Hospital of Youjiang Medical University for Nationalities, ²Key Laboratory of Medical Research Basic Guarantee for Immune-related Diseases Research of Guangxi, and ³Department of Ultrasound, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China
Background: Our aim was to systematically evaluate the efficacy and safety of rituximab (RTX) in patients with lupus nephritis (LN).
Materials and methods: PubMed, Embase, China National Knowledge Infrastructure (CNKI), Cochrane Library, and Wanfang Databases were searched to collect literature on the efficacy and safety of RTX in patients with LN. Odds ratios (ORs), weighted mean differences (WMDs), and standardized mean differences (SMDs) were used to represent treatment efficacy and overall outcome. The outcomes included complete renal remission rate, proteinuria, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores, serum creatinine, any adverse events and serious adverse events. We explored the heterogeneity with I² and assessed publication bias with funnel plot and Egger’s test.
Results: Nine studies involving 723 patients (254 in the RTX group and 469 in the control group) were included in our systematic review and meta-analysis. RTX resulted in a higher complete renal remission rate (OR: 2.62; 95% CI 1.43 – 4.79, p = 0.024, I² = 54.7%) than the control group. It significantly decreased SLEDAI scores (WMD = -3.79, 95% CI: –5.78 to –1.8, p < 0.001, I² = 94.7%) as well as proteinuria (WMD = -0.9, 95% CI: –1.6 to –0.2, p < 0.001, I² = 97.6%). There were no significant differences in any adverse events and serious adverse events between the RTX group and control group.
Conclusion: RTX was an effective therapeutic agent in patients with LN, and it did not increase the risk of adverse events compared to the control group.

*Co-first authors contributed equally to this study.Correspondence to:
Dr. Xu Lin and Dr. Qiuhong Zhong
Department of Nephrology
Affiliated Hospital of Youjiang Medical University for Nationalities
Key Laboratory of Medical Research Basic Guarantee for Immune-related Diseases
Research of Guangxi
Baise 53300, Guangxi, China
Email: [email protected]; [email protected]

Original

Safety and efficacy of nirmatrelvir and ritonavir in kidney transplant recipients with COVID-19 

Yadi Wang, Keqin Zhang, Ling Liu, Maozhi Tang, Ming Tang, Linguo Shen, Qiongyao Peng, Bangqin Hu, and Zhengsheng Rao

###ENGLISH_ABSTRACT_LINK### ###FREE_ENGLISH_ARTICLE_DOWNLIAD_LINK###

Volume 106 (2026) p. 96 - 109

Abstract

Clinical Nephrology, Vol. 106 – No. 2/2026 (96-109)

Safety and efficacy of nirmatrelvir and ritonavir in kidney transplant recipients with COVID-19 

Yadi Wang¹, Keqin Zhang¹, Ling Liu¹, Maozhi Tang¹, Ming Tang¹, Linguo Shen¹, Qiongyao Peng¹, Bangqin Hu², and Zhengsheng Rao¹

¹The Center of Urology and Nephrology, and ²Department of Pharmacy, The Affiliated Hospital of Chongqing Medical University, Chongqing, China
Kidney transplant recipients (KTRs) are at an elevated risks for severe COVID-19 due to immunosuppression and comorbidities. This study retrospectively evaluated the safety and efficacy of nirmatrelvir-ritonavir (NR) in 42 KTRs with COVID-19, adjusting dosages based on estimated glomerular filtration rates. Over a 1-year follow-up, renal and hepatic functions, inflammatory markers, and acute respiratory distress syndrome (ARDS) incidence were monitored. Within the studied cohort, oxygen therapy was required in 64% of patients, with 19% necessitating mechanical ventilation; 21% developed ARDS. Multivariate analysis identified higher albumin levels (odds ratio (OR) = 0.696, 95% confidence interval (CI) 0.515 – 0.940) and CD4⁺ T-cell counts (OR = 0.982, 95% CI 0.968 – 0.998) as protective against ARDS, with an AUC of 0.859. Significant reductions in serum creatinine (p < 0.001) and aspartate aminotransferase (p = 0.01) were observed from admission to discharge, while alanine aminotransferase and estimated glomerular filtration rate (eGFR) remained stable. Complications were rare, occurring in only 2 patients. NR therapy demonstrated safety and effectiveness in KTRs, evidenced by improvements in renal and hepatic function as well as stable graft outcomes. CD4+ T-cell counts and albumin levels were identified as potential predictors of ARDS. These findings underscore the significance of early antiviral intervention and meticulous optimization of immunosuppressive management. However, further validation through larger multicenter prospective studies is necessary.Correspondence to:
Keqin Zhang, MD
The Second Affiliated Hospital of Chongqing Medical University
No. 74 Linjiang Road
Yuzhong District, Chongqing 400010, China
Email: [email protected]

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