The results of a systematic review and meta-analysis of randomized controlled trials (RCTs) including rituximab combined with methotrexate (MTX) and MTX only indicate that the combination therapy offered significantly higher ACR20, ACR50, and ACR70 in rheumatoid arthritis patients as compared to the MTX alone. There was no difference between total complication and infection rates. An electronic search of PubMed, Google database, the Cochrane Library, and the Chinese Wanfang database was carried out to extract RCTs for the meta-analysis.  

The study outcomes were improvement in ACR20, ACR50, ACR70, total complications and infection rate. In the selected 5 RCTs, 3299 patients were in the rituximab-MTX group and 1512 were in MTX only group. This meta-analysis showed that the combination therapy was effective and safe for RA patients, long-term safety evaluation yet to be done in future.