Comparison 6. Glucocorticosteroid avoidance or withdrawal versus glucocorticosteroid‐containing immunosuppression (treatment duration subgroups).

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mortality	14	1149	Risk Ratio (M‐H, Fixed, 95% CI)	1.09 [0.87, 1.36]
1.1 2 to 3 months glucocorticosteroid	7	655	Risk Ratio (M‐H, Fixed, 95% CI)	0.99 [0.70, 1.41]
1.2 > 3 to 6 months glucocorticosteroids	3	250	Risk Ratio (M‐H, Fixed, 95% CI)	1.48 [1.00, 2.18]
1.3 > 6 months glucocorticosteroids	4	244	Risk Ratio (M‐H, Fixed, 95% CI)	0.86 [0.55, 1.33]
2 Graft loss including death	10	828	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.83, 1.37]
2.1 2 to 3 months glucocorticosteroid	5	492	Risk Ratio (M‐H, Fixed, 95% CI)	0.87 [0.59, 1.29]
2.2 > 3 to 6 months glucocorticosteroids	3	250	Risk Ratio (M‐H, Fixed, 95% CI)	1.44 [1.01, 2.04]
2.3 > 6 months glucocorticosteroids	2	86	Risk Ratio (M‐H, Fixed, 95% CI)	0.61 [0.25, 1.47]
3 Acute rejection	15	1173	Risk Ratio (M‐H, Fixed, 95% CI)	1.28 [1.01, 1.62]
3.1 2 to 3 months glucocorticosteroid	8	679	Risk Ratio (M‐H, Fixed, 95% CI)	1.30 [0.97, 1.75]
3.2 > 3 to 6 months glucocorticosteroids	3	250	Risk Ratio (M‐H, Fixed, 95% CI)	1.33 [0.83, 2.15]
3.3 > 6 months glucocorticosteroids	4	244	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.54, 2.12]
4 Infection	7	604	Risk Ratio (M‐H, Fixed, 95% CI)	0.90 [0.75, 1.08]
4.1 2 to 3 months glucocorticosteroid	4	360	Risk Ratio (M‐H, Fixed, 95% CI)	0.89 [0.71, 1.11]
4.2 > 3 to 6 months glucocorticosteroids	2	140	Risk Ratio (M‐H, Fixed, 95% CI)	1.12 [0.81, 1.54]
4.3 > 6 months glucocorticosteroids	1	104	Risk Ratio (M‐H, Fixed, 95% CI)	0.12 [0.02, 0.89]
5 Chronic rejection	8	800	Risk Ratio (M‐H, Fixed, 95% CI)	1.27 [0.59, 2.71]
5.1 2 to 3 months glucocorticosteroid	5	486	Risk Ratio (M‐H, Fixed, 95% CI)	1.23 [0.41, 3.73]
5.2 > 3 to 6 months glucocorticosteroids	2	210	Risk Ratio (M‐H, Fixed, 95% CI)	1.64 [0.51, 5.24]
5.3 > 6 months glucocorticosteroids	1	104	Risk Ratio (M‐H, Fixed, 95% CI)	0.31 [0.01, 7.42]
6 Glucocorticosteroid‐resistant rejection	9	846	Risk Ratio (M‐H, Fixed, 95% CI)	1.93 [0.93, 4.01]
6.1 2 to 3 months glucocorticosteroid	5	549	Risk Ratio (M‐H, Fixed, 95% CI)	1.88 [0.89, 3.98]
6.2 > 3 to 6 months glucocorticosteroids	3	250	Risk Ratio (M‐H, Fixed, 95% CI)	2.89 [0.12, 69.55]
6.3 > 6 months glucocorticosteroids	1	47	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Diabetes mellitus	11	1011	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.67, 1.03]
7.1 2 to 3 months glucocorticosteroid	6	610	Risk Ratio (M‐H, Fixed, 95% CI)	0.74 [0.54, 1.01]
7.2 > 3 to 6 months glucocorticosteroids	3	250	Risk Ratio (M‐H, Fixed, 95% CI)	1.16 [0.81, 1.66]
7.3 > 6 months glucocorticosteroids	2	151	Risk Ratio (M‐H, Fixed, 95% CI)	0.63 [0.39, 1.03]
8 CMV infection	6	612	Risk Ratio (M‐H, Fixed, 95% CI)	0.76 [0.48, 1.18]
8.1 2 to 3 months glucocorticosteroid	4	462	Risk Ratio (M‐H, Fixed, 95% CI)	0.76 [0.39, 1.49]
8.2 > 3 to 6 months glucocorticosteroids	2	150	Risk Ratio (M‐H, Fixed, 95% CI)	0.75 [0.42, 1.35]
9 HCV recurrence	9	369	Risk Ratio (M‐H, Fixed, 95% CI)	1.01 [0.89, 1.15]
9.1 2 to 3 months glucocorticosteroid	5	198	Risk Ratio (M‐H, Fixed, 95% CI)	0.99 [0.88, 1.12]
9.2 > 3 to 6 months glucocorticosteroids	2	76	Risk Ratio (M‐H, Fixed, 95% CI)	0.82 [0.55, 1.22]
9.3 > 6 months glucocorticosteroids	2	95	Risk Ratio (M‐H, Fixed, 95% CI)	1.37 [0.89, 2.09]
10 Creatinine	4	309	Mean Difference (IV, Fixed, 95% CI)	0.11 [0.07, 0.16]
10.1 > 6 months glucocorticosteroids	1	45	Mean Difference (IV, Fixed, 95% CI)	‐0.10 [‐0.19, ‐0.01]
10.2 2 to 3 months glucocorticosteroid	2	210	Mean Difference (IV, Fixed, 95% CI)	0.24 [0.18, 0.30]
10.3 > 3 to 6 months glucocorticosteroids	1	54	Mean Difference (IV, Fixed, 95% CI)	‐0.05 [‐0.16, 0.06]
11 Hypertension	9	924	Risk Ratio (M‐H, Fixed, 95% CI)	0.75 [0.63, 0.89]
11.1 2 to 3 months glucocorticosteroid	6	610	Risk Ratio (M‐H, Fixed, 95% CI)	0.72 [0.57, 0.92]
11.2 > 3 to 6 months glucocorticosteroids	2	210	Risk Ratio (M‐H, Fixed, 95% CI)	1.06 [0.80, 1.40]
11.3 > 6 months glucocorticosteroids	1	104	Risk Ratio (M‐H, Fixed, 95% CI)	0.30 [0.16, 0.57]
12 Cholesterol	6	611	Mean Difference (IV, Fixed, 95% CI)	‐18.49 [‐22.02, ‐14.96]
12.1 2 to 3 months glucocorticosteroid	2	243	Mean Difference (IV, Fixed, 95% CI)	‐11.00 [‐23.43, 1.43]
12.2 > 3 to 6 months glucocorticosteroids	2	210	Mean Difference (IV, Fixed, 95% CI)	‐17.55 [‐21.27, ‐13.83]
12.3 > 6 months glucocorticosteroids	2	158	Mean Difference (IV, Fixed, 95% CI)	‐92.75 [‐118.01, ‐67.50]
13 Hypercholesterolaemia	2	266	Risk Ratio (M‐H, Fixed, 95% CI)	0.56 [0.32, 1.00]
13.1 2 to 3 months glucocorticosteroid	1	156	Risk Ratio (M‐H, Fixed, 95% CI)	1.2 [0.55, 2.61]
13.2 > 3 to 6 months glucocorticosteroids	1	110	Risk Ratio (M‐H, Fixed, 95% CI)	0.21 [0.08, 0.59]