Table 5.
Comparison of all lupus nephritis treatments for bone marrow toxicity (cytopenia including leucopenia)
| Treatment | Reference | OR (95 % CrI) | RR (95 % CrI) | RD % (95 % Crl) |
|---|---|---|---|---|
| CYC SD | MMF | 2.16 (1.14, 4.03) | 1.99 (1.13, 3.37) | 0.07 (0.01, 0.16) |
| AZA SD | 2.42 (1.01, 7.07) | 2.19 (1.01, 5.06) | 0.09 (0.00, 0.27) | |
| CYC LD | 5.31 (1.26, 24.65) | 4.03 (1.23, 10.11) | 0.22 (0.02, 0.56) | |
| CYC HD | 5.36 (1.95, 18.08) | 4.06 (1.81, 8.96) | 0.22 (0.07, 0.48) | |
| RTX + MMF SD | 3.50 (0.61, 23.14) | 2.95 (0.63, 9.43) | 0.14 (−0.03, 0.56) | |
| AZA SD | CYC SD | 1.11 (0.39, 4.03) | 1.09 (0.44, 3.07) | 0.01 (−0.11, 0.22) |
| CYC LD | 2.45 (0.51, 13.07) | 2.01 (0.56, 5.91) | 0.15 (−0.08, 0.50) | |
| CYC HD | 2.47 (0.77, 9.99) | 2.03 (0.80, 5.38) | 0.15 (−0.04, 0.43) | |
| RTX + MMF SD | 1.63 (0.26, 11.77) | 1.49 (0.30, 5.31) | 0.07 (−0.13, 0.49) | |
| CYC LD | AZA SD | 2.16 (0.42, 10.83) | 1.80 (0.49, 5.39) | 0.13 (−0.12, 0.47) |
| CYC HD | 2.20 (0.56, 8.96) | 1.83 (0.65, 5.16) | 0.13 (−0.10, 0.40) | |
| RTX + MMF SD | 1.43 (0.18, 11.42) | 1.33 (0.23, 5.33) | 0.05 (−0.21, 0.48) | |
| CYC HD | CYC LD | 1.01 (0.29, 3.75) | 1.01 (0.46, 2.74) | 0.00 (−0.28, 0.24) |
| RTX + MMF SD | 0.66 (0.06, 7.15) | 0.74 (0.12, 3.78) | −0.07 (−0.48, 0.40) | |
| RTX + MMF SD | CYC HD | 0.65 (0.08, 5.36) | 0.73 (0.13, 2.81) | −0.08 (−0.41, 0.37) |
| Random-effects model | Residual deviance | 31.43 vs. 33 data points | ||
| Deviance information criteria | 165.076 | |||
| Fixed-effects model | Residual deviance | 38.78 vs. 33 data points | ||
| Deviance information criteria | 167.984 |
Based on 16 RCTs with 2257 patients: 15 two-arm trials and one three-arm trial
Significant odds ratios are in italics
For absolute rates for events used for calculation of risk difference, please see Appendix 6
OR odds ratio, RR relative risk, RD risk difference, CrI credible interval, HD high dose, LD low dose; when not specified, it indicates standard dose, CYC cyclophosphamide, MMF mycophenolate mofetil, CSA cyclosporine, TAC tacrolimus, LEF leflunomide, PRED prednisone, prednisolone or methylprednisolone, AZA azathioprine, RTX rituximab
MMF-AZA, MMF followed by AZA
RTX + MMF, RTX combined with MMF
Estimates for LEF HD were obtained from data from only one study and were therefore imprecise
The odds ratios were transformed to relative risk (RR) and risk difference was done to allow ease for interpretation for clinicians and patients