Comparison 8. Glucocorticosteroid avoidance or withdrawal versus glucocorticosteroid‐containing immunosuppression (best‐worst analysis).

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mortality	16	1347	Risk Ratio (M‐H, Fixed, 95% CI)	0.99 [0.80, 1.22]
1.1 Glucocorticosteroid avoidance	10	782	Risk Ratio (M‐H, Fixed, 95% CI)	1.15 [0.87, 1.52]
1.2 Glucocorticosteroid withdrawal	6	565	Risk Ratio (M‐H, Fixed, 95% CI)	0.82 [0.60, 1.12]
2 Graft loss including death	11	1002	Risk Ratio (M‐H, Fixed, 95% CI)	0.98 [0.78, 1.24]
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)	0.90 [0.61, 1.33]
3 Acute rejection	16	1347	Risk Ratio (M‐H, Fixed, 95% CI)	1.04 [0.85, 1.26]
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)	0.78 [0.59, 1.02]
4 Infection	8	778	Risk Ratio (M‐H, Fixed, 95% CI)	0.80 [0.67, 0.96]
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)	0.24 [0.12, 0.50]
5 Chronic rejection	9	974	Risk Ratio (M‐H, Fixed, 95% CI)	0.59 [0.33, 1.05]
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)	0.48 [0.23, 1.02]
6 Glucocorticosteroid‐resistant rejection	10	1020	Risk Ratio (M‐H, Fixed, 95% CI)	1.00 [0.61, 1.65]
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)	0.55 [0.27, 1.13]
7 Diabetes mellitus	12	1185	Risk Ratio (M‐H, Fixed, 95% CI)	0.71 [0.58, 0.86]
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)	0.52 [0.39, 0.70]
8 CMV infection	7	786	Risk Ratio (M‐H, Fixed, 95% CI)	0.57 [0.37, 0.87]
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)	0.46 [0.27, 0.81]
9 Malignancy	3	528	Risk Ratio (M‐H, Fixed, 95% CI)	0.21 [0.07, 0.61]
9.1 Glucocorticosteroid avoidance	2	354	Risk Ratio (M‐H, Fixed, 95% CI)	0.52 [0.13, 2.08]
9.2 Glucocorticosteroid withdrawal	1	174	Risk Ratio (M‐H, Fixed, 95% CI)	0.08 [0.01, 0.57]
10 Post‐transplant lymphoproliferative disorder	2	330	Risk Ratio (M‐H, Fixed, 95% CI)	0.24 [0.07, 0.85]
10.1 Glucocorticosteroid avoidance	1	156	Risk Ratio (M‐H, Fixed, 95% CI)	2.0 [0.19, 21.61]
10.2 Glucocorticosteroid withdrawal	1	174	Risk Ratio (M‐H, Fixed, 95% CI)	0.09 [0.01, 0.67]
11 Hypertension	10	1098	Risk Ratio (M‐H, Fixed, 95% CI)	0.70 [0.60, 0.82]
11.1 Glucocorticosteroid avoidance	6	634	Risk Ratio (M‐H, Fixed, 95% CI)	0.81 [0.66, 1.00]
11.2 Glucocorticosteroid withdrawal	4	464	Risk Ratio (M‐H, Fixed, 95% CI)	0.59 [0.47, 0.76]
12 Hyperlipidaemia	4	400	Risk Ratio (M‐H, Fixed, 95% CI)	0.40 [0.21, 0.73]
12.1 Glucocorticosteroid avoidance	2	150	Risk Ratio (M‐H, Fixed, 95% CI)	1.06 [0.45, 2.52]
12.2 Glucocorticosteroid withdrawal	2	250	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.06, 0.45]