Tratamento da miastenia gravis com rituximabe: uma revisão sistemática e metanálise

Abstract

Objectives: Myasthenia Gravis (MG) is an autoimmune neuromuscular disease that is cha-racterized by muscle weakness and fatigue. Despite the availability of several therapeutic op-tions, some patients show inadequate response or intolerance to conventional treatments. In this context, rituximab emerges as a promising alternative. This study aims to analyse the effi-cacy and role of rituximab in the treatment of myasthenia gravis. Methodology: A systematic review and meta-analysis were conducted, involving searches in the databases PubMed, EMBASE, LILACS, Cochrane Library, and Web of Science until January 2024. Studies evaluating rituximab in any dosage and infusion regimen in patients with a clinical diagnosis of myasthenia gravis were included. Results: Of the 3188 articles initially identified, 34 studies met the inclusion criteria, totaling 725 participants. The results demonstrated that 65.7% of the patients achieved a status of mi-nimal manifestation or better on the Myasthenia Gravis Foundation of America Post-intervention Status (MGFA-PIS) scale. Additionally, the analysis revealed a significant re-duction in the dose of corticosteroids and improvements in the scores of the Quantitative Myasthenia Gravis (QMG), Myasthenia Gravis Activities of Daily Living (MG-ADL), and Myasthenia Gravis Quality of Life (MG-QoL15) scales, indicating improvement in symp-toms and quality of life. Conclusion: Rituximab proved to be an effective alternative for controlling Myasthenia Gra-vis, significantly improving symptoms and reducing the need for corticosteroids. However, further randomized and controlled studies are needed to definitively establish its safety and efficacy in the long term.