5 Comparing with initial value, there was a reduction in TRAbs at 6 (a) and 12 (b) month after RTX treatment for TAO Open in a separate window Fig. therapies of thyroid-associated ophthalmopathy (TAO) were still a demanding matter. In this study, we targeted to contrast the effect of before- after rituximab (RTX) therapy in the individuals with TAO. Methods We looked the PubMed, EMBASE, and SCOPUS databases for content articles published up to July 3, 2017. Fixed- or random-effects meta-analysis was used to provide pooled estimations of standard imply difference (SMD) both the primary end result from medical activity score (CAS), and secondary results from thyrotropin receptor antibody (TRAb), proptosis, thyroid revitalizing hormone (TSH), and interleukin-6 (IL-6) levels. In addition, the quality and each study was assessed using either the Newcastle Ottawa Level (NOS) or the Cochrane Risk of Bias tool, and reliability of the meta-analytic result using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results Of the 839 content articles in the beginning looked, 11 studies were finally eligible for inclusion. Subgroup analysis results showed that comparing with initial value, there was a decrease in CAS at 1,3,6,12?month after BX471 hydrochloride RTX treatment, decreased TRAbs level at 6,12?month, proptosis improvement at least 1?month, unchanged IL-6 level at 6?month, decreased TSH level at 3?month but unchanged at 12?month. All included studies were classified as good quality. Conclusions The pooled data suggested the initial effects of BX471 hydrochloride RTX treatment on TAO might be encouraging. However, more large-sample and high-quality studies targeting RTX use during this disease and long-term monitoring of prognosis are urgently needed. Electronic supplementary material The online version of this article (10.1186/s12886-018-0679-4) contains supplementary material, which is available to authorized users. and statistic. Where not available Heterogeneity test result and subgroup analysis In view of the initial CAS value, results indicated significant decrease at 1,3,6,12?weeks after subsequent RTX treatment (1?month, SMD 95% CI: 4.77 (2.77C6.77); 3?month, SMD 95% CI: 3.89 (1.67C6.11); 6?month, SMD 95% CI: 3.59 (1.83C5.35); 12?month, SMD 95% CI: 3.04 (1.58C4.50)) (Figs.?2 and ?and3,3, Additional?file?6: Table S3). At last month of follow-up, proptosis improvement was demonstrated (last month of follow-up, SMD 95% CI: 0.97 (0.10C1.84)) (Fig.?4). Similarly, pooled data reported TRAbs level were both declining at 6 and 12?weeks (6?month, SMD 95% CI: 0.82 (0.40C1.25); 12?month, SMD 95% CI: 1.52 (0.80C2.24)) (Fig.?5). TSH level was decreased at 2?month while unchanged at 12?month (2?month, SMD 95% CI: 0.69 (0.14C1.25); 12?month, SMD 95% CI: 0.39 (??0.74C1.52)) (Fig.?6). In addition, IL-6 level was also not see an obvious variance (6?month, SMD 95% CI: 6.47 (??3.26C16.21)) (Fig.?7). In Additional file 6: Table S3, subgroup analysis listed heterogeneity test using em I /em em 2 /em , in which the substantial heterogeneity ( em I /em em 2 /em ? ?75%) was dealed with random-effects model (CAS: 1,3,6,12?month: 84.4%, 87.4%, 94.3%,77.2%; proptosis: at least 1?month: 80%; TSH: 12?month: 76.7%; IL-6: 6?month: 99.3%). BX471 hydrochloride Open in a separate windowpane Fig. 2 Comparing with initial value, there was a decrease in CAS at 1 (a) and 3 (b) month after RTX treatment for TAO Open in a separate windowpane Fig. 3 Comparing with initial value, there was a decrease in CAS at 6 (a) and 12 (b) month after RTX treatment for TAO Open in a separate windowpane Fig. 4 Comparing with initial value, there was a decrease in proptosis at least 1?month after RTX treatment for TAO Open in a separate windowpane Fig. 5 Comparing with initial value, there was a reduction in TRAbs at 6 (a) and 12 (b) month after RTX treatment for TAO Open in a separate windowpane Fig. 6 Comparing with initial value, there was a decrease in TSH at 3?month (a) but unchangeable at 12 (b) month after RTX treatment for TAO PDGFRA Open in a separate windowpane Fig. 7 Comparing with initial value, there.