Summary of findings 5. Tacrolimus versus mycophenolate mofetil to maintain remission for idiopathic steroid‐resistant nephrotic syndrome in children.
| Tacrolimus versus mycophenolate mofetil to maintain remission for idiopathic steroid‐resistant nephrotic syndrome in children | |||||
| Patient or population: idiopathic steroid‐resistant nephrotic syndrome in children Setting: paediatric nephrology services Intervention: tacrolimus to maintain remission Comparison: mycophenolate mofetil (MMF) to maintain remission | |||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Certainty of the evidence (GRADE) | |
| Risk with MMF to maintain remission | Risk with tacrolimus | ||||
| Number with complete or partial response at one year | 448 per 1,000 | 901 per 1,000 (592 to 1,000) | RR 2.01 (1.32 to 3.07) | 60 (1) | ⊕⊕⊝⊝ LOW 1 2 |
| Number with complete response at one year | 414 per 1,000 | 741 per 1,000 (459 to 1,000) | RR 1.79 (1.11 to 2.90) | 60 (1) | ⊕⊕⊝⊝ LOW 1 2 |
| Number with partial response at one year | 34 per 1,000 | 161 per 1,000 (20 to 1,000) | RR 4.68 (0.58 to 37.68) | 60 (1) | ⊕⊕⊝⊝ LOW 1 2 |
| Number with treatment failure by one year | 552 per 1,000 | 99 per 1,000 (33 to 298) | RR 0.18 (0.06 to 0.54) | 60 (1) | ⊕⊕⊝⊝ LOW 1 2 |
| Number with frequent relapses by one year | 345 per 1,000 | 97 per 1,000 (31 to 317) | RR 0.28 (0.09 to 0.92) | 60 (1) | ⊕⊕⊝⊝ LOW 1 2 |
| Number with steroid resistance by one year | 207 per 1,000 | 14 per 1,000 (0 to 254) | RR 0.07 (0.00 to 1.23) | 60 (1) | ⊕⊕⊝⊝ LOW 1 2 |
| Change in GFR | Change in GFR was 13 mL/min higher with tacrolimus (3.71 lower to 29.71 higher) compared to MMF | ‐ | 60 (1) | ⊕⊕⊝⊝ LOW 1 2 | |
| *The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio | |||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | |||||
1 Unclear how primary outcome of continuing remission was measured and whether it was blinded
2 Small study with few events