Comparison 9. Glucocorticosteroid avoidance or withdrawal versus glucocorticosteroid‐containing immunosuppression (worst‐best 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)	1.35 [1.10, 1.67]
1.1 Glucocorticosteroid avoidance	10	782	Risk Ratio (M‐H, Fixed, 95% CI)	1.13 [0.86, 1.49]
1.2 Glucocorticosteroid withdrawal	6	565	Risk Ratio (M‐H, Fixed, 95% CI)	1.71 [1.23, 2.38]
2 Graft loss including death	11	1002	Risk Ratio (M‐H, Fixed, 95% CI)	1.38 [1.08, 1.74]
2.1 Glucocorticosteroid avoidance	8	671	Risk Ratio (M‐H, Fixed, 95% CI)	1.05 [0.78, 1.41]
2.2 Glucocorticosteroid withdrawal	3	331	Risk Ratio (M‐H, Fixed, 95% CI)	2.24 [1.47, 3.41]
3 Acute rejection	16	1347	Risk Ratio (M‐H, Fixed, 95% CI)	1.53 [1.25, 1.88]
3.1 Glucocorticosteroid avoidance	10	782	Risk Ratio (M‐H, Fixed, 95% CI)	1.38 [1.05, 1.83]
3.2 Glucocorticosteroid withdrawal	6	565	Risk Ratio (M‐H, Fixed, 95% CI)	1.73 [1.29, 2.31]
4 Infection	8	778	Risk Ratio (M‐H, Fixed, 95% CI)	1.03 [0.87, 1.23]
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)	1.50 [0.89, 2.50]
5 Chronic rejection	9	974	Risk Ratio (M‐H, Fixed, 95% CI)	2.45 [1.40, 4.31]
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)	4.87 [2.16, 11.01]
6 Glucocorticosteroid‐resistant rejection	10	1020	Risk Ratio (M‐H, Fixed, 95% CI)	3.71 [2.07, 6.66]
6.1 Glucocorticosteroid avoidance	7	689	Risk Ratio (M‐H, Fixed, 95% CI)	1.99 [0.95, 4.17]
6.2 Glucocorticosteroid withdrawal	3	331	Risk Ratio (M‐H, Fixed, 95% CI)	8.63 [2.95, 25.28]
7 Diabetes mellitus	12	1185	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.79, 1.15]
7.1 Glucocorticosteroid avoidance	7	674	Risk Ratio (M‐H, Fixed, 95% CI)	0.92 [0.71, 1.19]
7.2 Glucocorticosteroid withdrawal	5	511	Risk Ratio (M‐H, Fixed, 95% CI)	1.00 [0.76, 1.32]
8 CMV infection	7	786	Risk Ratio (M‐H, Fixed, 95% CI)	1.29 [0.87, 1.90]
8.1 Glucocorticosteroid avoidance	5	502	Risk Ratio (M‐H, Fixed, 95% CI)	0.81 [0.41, 1.59]
8.2 Glucocorticosteroid withdrawal	2	284	Risk Ratio (M‐H, Fixed, 95% CI)	1.70 [1.04, 2.78]
9 Malignancy	3	528	Risk Ratio (M‐H, Fixed, 95% CI)	3.05 [1.38, 6.73]
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)	10.71 [2.58, 44.45]
10 Post‐transplant lymphoproliferative disorder	2	330	Risk Ratio (M‐H, Fixed, 95% CI)	15.64 [3.08, 79.56]
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)	43.89 [2.70, 714.49]
11 Renal insufficiency	4	447	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.75, 1.21]
11.1 Glucocorticosteroid avoidance	4	447	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.75, 1.21]
12 Hypertension	10	1098	Risk Ratio (M‐H, Fixed, 95% CI)	0.87 [0.75, 1.02]
12.1 Glucocorticosteroid avoidance	6	634	Risk Ratio (M‐H, Fixed, 95% CI)	0.82 [0.67, 1.01]
12.2 Glucocorticosteroid withdrawal	4	464	Risk Ratio (M‐H, Fixed, 95% CI)	0.94 [0.75, 1.18]
13 Hyperlipidaemia	4	400	Risk Ratio (M‐H, Fixed, 95% CI)	1.92 [1.12, 3.28]
13.1 Glucocorticosteroid avoidance	2	150	Risk Ratio (M‐H, Fixed, 95% CI)	1.18 [0.51, 2.73]
13.2 Glucocorticosteroid withdrawal	2	250	Risk Ratio (M‐H, Fixed, 95% CI)	2.64 [1.28, 5.44]