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. 2018 Apr 9;2018(4):CD007606. doi: 10.1002/14651858.CD007606.pub4

Comparison 1. Glucocorticosteroid avoidance or withdrawal versus glucocorticosteroid‐containing immunosuppression.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 Mortality 15 1323 Risk Ratio (M‐H, Fixed, 95% CI) 1.15 [0.93, 1.44]
1.1 Glucocorticosteroid avoidance 9 758 Risk Ratio (M‐H, Fixed, 95% CI) 1.11 [0.84, 1.48]
1.2 Glucocorticosteroid withdrawal 6 565 Risk Ratio (M‐H, Fixed, 95% CI) 1.22 [0.86, 1.72]
2 Graft loss including death 11 1002 Risk Ratio (M‐H, Fixed, 95% CI) 1.15 [0.90, 1.46]
2.1 Glucocorticosteroid avoidance 8 671 Risk Ratio (M‐H, Fixed, 95% CI) 1.03 [0.77, 1.39]
2.2 Glucocorticosteroid withdrawal 3 331 Risk Ratio (M‐H, Fixed, 95% CI) 1.44 [0.93, 2.24]
3 Acute rejection 16 1347 Risk Ratio (M‐H, Fixed, 95% CI) 1.33 [1.08, 1.64]
3.1 Glucocorticosteroid avoidance 10 782 Risk Ratio (M‐H, Fixed, 95% CI) 1.37 [1.04, 1.81]
3.2 Glucocorticosteroid withdrawal 6 565 Risk Ratio (M‐H, Fixed, 95% CI) 1.28 [0.93, 1.76]
4 Infection 8 778 Risk Ratio (M‐H, Fixed, 95% CI) 0.88 [0.73, 1.05]
4.1 Glucocorticosteroid avoidance 6 500 Risk Ratio (M‐H, Fixed, 95% CI) 0.96 [0.80, 1.15]
4.2 Glucocorticosteroid withdrawal 2 278 Risk Ratio (M‐H, Fixed, 95% CI) 0.41 [0.19, 0.90]
5 Chronic rejection 9 974 Risk Ratio (M‐H, Fixed, 95% CI) 1.08 [0.56, 2.10]
5.1 Glucocorticosteroid avoidance 6 586 Risk Ratio (M‐H, Fixed, 95% CI) 0.82 [0.32, 2.08]
5.2 Glucocorticosteroid withdrawal 3 388 Risk Ratio (M‐H, Fixed, 95% CI) 1.45 [0.55, 3.78]
6 Glucocorticosteroid‐resistant rejection 10 1020 Risk Ratio (M‐H, Fixed, 95% CI) 2.14 [1.13, 4.02]
6.1 Glucocorticosteroid avoidance 7 689 Risk Ratio (M‐H, Fixed, 95% CI) 1.88 [0.89, 3.98]
6.2 Glucocorticosteroid withdrawal 3 331 Risk Ratio (M‐H, Fixed, 95% CI) 2.86 [0.86, 9.49]
7 Diabetes mellitus 12 1185 Risk Ratio (M‐H, Fixed, 95% CI) 0.81 [0.66, 0.99]
7.1 Glucocorticosteroid avoidance 7 674 Risk Ratio (M‐H, Fixed, 95% CI) 0.90 [0.70, 1.17]
7.2 Glucocorticosteroid withdrawal 5 511 Risk Ratio (M‐H, Fixed, 95% CI) 0.68 [0.50, 0.94]
8 CMV 7 786 Risk Ratio (M‐H, Fixed, 95% CI) 0.74 [0.48, 1.16]
8.1 Glucocorticosteroid avoidance 5 502 Risk Ratio (M‐H, Fixed, 95% CI) 0.76 [0.39, 1.49]
8.2 Glucocorticosteroid withdrawal 2 284 Risk Ratio (M‐H, Fixed, 95% CI) 0.73 [0.41, 1.30]
9 HCV recurrence 10 477 Risk Ratio (M‐H, Fixed, 95% CI) 1.03 [0.92, 1.15]
9.1 Glucocorticosteroid avoidance 7 274 Risk Ratio (M‐H, Fixed, 95% CI) 0.95 [0.84, 1.08]
9.2 Glucocorticosteroid withdrawal 3 203 Risk Ratio (M‐H, Fixed, 95% CI) 1.18 [0.96, 1.44]
10 Malignancy 3 528 Risk Ratio (M‐H, Fixed, 95% CI) 0.52 [0.16, 1.74]
10.1 Glucocorticosteroid avoidance 2 354 Risk Ratio (M‐H, Fixed, 95% CI) 0.52 [0.13, 2.08]
10.2 Glucocorticosteroid withdrawal 1 174 Risk Ratio (M‐H, Fixed, 95% CI) 0.54 [0.05, 5.80]
11 Post‐transplant lymphoproliferative disorder 2 330 Risk Ratio (M‐H, Fixed, 95% CI) 2.39 [0.36, 15.95]
11.1 Glucocorticosteroid avoidance 1 156 Risk Ratio (M‐H, Fixed, 95% CI) 2.0 [0.19, 21.61]
11.2 Glucocorticosteroid withdrawal 1 174 Risk Ratio (M‐H, Fixed, 95% CI) 3.21 [0.13, 77.77]
12 Renal insufficiency 4 447 Risk Ratio (M‐H, Fixed, 95% CI) 0.93 [0.73, 1.19]
12.1 Glucocorticosteroid avoidance 4 447 Risk Ratio (M‐H, Fixed, 95% CI) 0.93 [0.73, 1.19]
13 Creatinine 4 309 Mean Difference (IV, Fixed, 95% CI) 0.11 [0.07, 0.16]
13.1 Glucocorticosteroid avoidance 2 145 Mean Difference (IV, Fixed, 95% CI) 0.15 [0.10, 0.20]
13.2 Glucocorticosteroid withdrawal 2 164 Mean Difference (IV, Fixed, 95% CI) ‐0.06 [‐0.16, 0.05]
14 Hypertension 10 1098 Risk Ratio (M‐H, Fixed, 95% CI) 0.76 [0.65, 0.90]
14.1 Glucocorticosteroid avoidance 6 634 Risk Ratio (M‐H, Fixed, 95% CI) 0.81 [0.66, 1.00]
14.2 Glucocorticosteroid withdrawal 4 464 Risk Ratio (M‐H, Fixed, 95% CI) 0.71 [0.55, 0.91]
15 Hyperlipidaemia 4 400 Risk Ratio (M‐H, Fixed, 95% CI) 0.75 [0.38, 1.48]
15.1 Glucocorticosteroid avoidance 2 150 Risk Ratio (M‐H, Fixed, 95% CI) 1.06 [0.45, 2.52]
15.2 Glucocorticosteroid withdrawal 2 250 Risk Ratio (M‐H, Fixed, 95% CI) 0.44 [0.14, 1.41]
16 Cholesterol 6 611 Mean Difference (IV, Fixed, 95% CI) ‐18.49 [‐22.02, ‐14.96]
16.1 Glucocorticosteroid avoidance 3 343 Mean Difference (IV, Fixed, 95% CI) ‐18.33 [‐21.93, ‐14.72]
16.2 Glucocorticosteroid withdrawal 3 268 Mean Difference (IV, Fixed, 95% CI) ‐22.06 [‐38.94, ‐5.18]
17 Hypercholesterolaemia 2 266 Risk Ratio (M‐H, Fixed, 95% CI) 0.56 [0.32, 1.00]
17.1 Glucocorticosteroid avoidance 1 156 Risk Ratio (M‐H, Fixed, 95% CI) 1.2 [0.55, 2.61]
17.2 Glucocorticosteroid withdrawal 1 110 Risk Ratio (M‐H, Fixed, 95% CI) 0.21 [0.08, 0.59]