Intravenous immune globin (IVIG) is used to treat immunoglobulin deficiency and autoimmune diseases. However, other immune-modulating drugs, such as rituximab, are also an attractive alternatives. Rituximab, originally approved to treat B-cell lymphoma, is an anti-CD20 monoclonal antibody that targets B-cells. Since B-cell depletion can also improve autoimmune diseases, rituximab has been used to treat chronic inflammatory demyelinating polyneuropathy (CIDP), immune thrombocytopenia (ITP), myasthenia gravis, multifocal motor neuropathy, Guillain-Barrè syndrome, systemic lupus erythematosus (SLE), Sjogren’s syndrome, and pemphigus vulgaris as an alternative to IVIG. Since there is limited evidence for safety and efficacy of rituximab compared to IVIG for the treatment of autoimmune diseases, researchers in Canada performed a systematic review and meta-analysis to compare the two treatments. Based on 85 observational studies and 9 randomized controlled trials, rituximab was considered to be safe and effective with a range of positive clinical responses from 94% for patients with pemphigus vulgaris to 48% for patients with CIDP. Additional randomized controlled trials are needed to compare the safety and efficacy of rituximab for the treatment of autoimmune diseases.
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