Table 5.
Meta-regression*, to explore possible confounding effects on summary risk of graft loss censored for death, acute rejection, and new insulin treated diabetes mellitus, within one year after transplantation
|
Graft loss, censored for death
|
Acute rejection
|
New insulin treated diabetes mellitus
|
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|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Potential confounder | Unadjusted ratio of relative risk (95% CI) | P value | Adjusted ratio of relative risk (95% CI)† | P value | Unadjusted ratio of relative risk (95% CI) | P value | Adjusted ratio of relative risk (95% CI)† | P value | Unadjusted ratio of relative risk (95% CI) | P value | Adjusted ratio of relative risk (95% CI)† | P value |
| Ciclosporin microemulsion v solution | 0.83 (0.49 to 1.40) | 0.48 | 1.01 (0.52 to 1.95) | 0.97 | 1.10 (0.88 to 1.36) | 0.40 | 0.99 (0.78 to 1.28) | 0.99 | 0.35 (0.17 to 0.74) | 0.006 | 0.30 (0.13 to 0.66) | 0.003 |
| Ciclosporin concentration, per 25 ng/m‡ | 1.02 (0.89 to 1.17) | 0.76 | 0.92 (0.77 to 1.11) | 0.38 | 1.06 (1.01 to 1.11) | 0.02 | 1.07 (0.98 to 1.17) | 0.14 | 1.03 (0.79 to 1.33) | 0.83 | 1.05 (0.86 to 1.29) | 0.61 |
| Tacrolimus concentration, per 1 ng/m‡ | 1.20 (1.02 to 1.41) | 0.04 | 1.33 (1.02 to 1.74) | 0.04 | 1.04 (0.99 to 1.08) | 0.10 | 0.98 (0.83 to 1.14) | 0.77 | 1.20 (1.05 to 1.38) | 0.007 | 1.18 (0.97 to 1.45) | 0.10 |
| Mycophenolate v azathioprine | 0.73 (0.23 to 2.29) | 0.59 | NA | NA | 1.47 (0.88 to 2.48) | 0.14 | 0.99 (0.52 to 1.91) | 0.98 | 0.53 (0.12 to 1.69) | 0.29 | NA | NA |
Results are expressed as the ratio of the relative risk with each potential modifier, compared with the relative risk of the reference category of that confounder. Ratios <1 correspond to a smaller treatment relative risk for trials with that reference characteristic, so reflecting larger benefit for that characteristic.
Adjusted ratio for each outcome is for multivariate model containing all explanatory variables that have an adjusted ratio quoted. NA=not available. Insufficient data reported across trials, so limiting the number of possible confounders that could be controlled for in the multivariate model. Multivariate model limited to those factors felt, a priori, to be of most clinical interest and have greatest potential to confound the analysis.
Ciclopsorin and tacrolimus concentrations calculated by taking weighted average of stated “intention to treat” target range concentrations, at the 12 hour post-dose nadir, over the first year after transplantation, in ng/ml.