Tratamento da miastenia gravis com rituximabe
uma revisão sistemática e metanálise
DOI:
https://doi.org/10.63162/v66n68e25614Palavras-chave:
Doenças da junção neuromuscular, Metanálise, Miastenia gravis, Revisão sistemática, RituximabResumo
Objetivos: A Miastenia Gravis (MG) é uma doença neuromuscular autoimune caracterizada pela fraqueza e fadiga muscular. Apesar de diversas opções terapêuticas disponíveis, alguns pacientes apresentam resposta inadequada ou intolerância aos tratamentos convencionais. Nesse contexto, o rituximabe surge como alternativa promissora. O presente estudo tem como objetivo analisar a eficácia e o papel do rituximabe no tratamento da miastenia gravis. Metodologia: Realizou-se uma revisão sistemática e metanálise, envolvendo buscas nas bases de dados Pubmed, EMBASE, LILACS, Cochrane Library e Web of Science até janeiro de 2024. Foram incluídos estudos que avaliaram o rituximabe em qualquer dosagem e regime de infusão em pacientes com diagnóstico clínico de Miastenia Gravis. Resultados: De 3188 artigos inicialmente identificados, 34 estudos preencheram os critérios de inclusão, totalizando 725 participantes. Os resultados demonstraram que 65,7% dos pacientes atingiram um status de manifestação mínima ou melhor na escala Myasthenia Gravis Foundation of America Post-intervention Status (MGFA-PIS). A análise também revelou uma redução significativa na dose de corticosteroides e melhorias nas pontuações das escalas Quantitative Myasthenia Gravis (QMG), Myasthenia Gravis Activities of Daily Living (MG-ADL), and Myasthenia Gravis Quality of Life (MG-QoL15), indicando melhora dos sintomas e da qualidade de vida. Discussão: O Rituximabe mostrou ser uma alternativa eficaz para o controle da Miastenia Gravis, melhorando significativamente os sintomas e reduzindo a necessidade de corticosteroides. Contudo, é necessária a realização de mais estudos randomizados e controlados para estabelecer definitivamente sua segurança e eficácia a longo prazo.
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