Summary of findings 7. IV versus oral cyclophosphamide for idiopathic steroid‐resistant nephrotic syndrome in children.
| IV versus oral cyclophosphamide for idiopathic steroid‐resistant nephrotic syndrome in children | |||||
| Patient or population: idiopathic steroid‐resistant nephrotic syndrome in children Setting: paediatric nephrology services Intervention: IV cyclophosphamide (CPA) Comparison: oral CPA | |||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Certainty of the evidence (GRADE) | |
| Risk with oral CPA | Risk with IV CPA | ||||
| Complete remission | 414 per 1,000 | 654 per 1,000 (269 to 1,000) | RR 1.58 (0.65 to 3.85) | 61 (2) | ⊕⊕⊝⊝ LOW 1 2 |
| Partial remission | 80 per 1,000 | 80 per 1,000 (12 to 524) | RR 1.00 (0.15 to 6.55) | 50 (1) | ⊕⊕⊝⊝ LOW 3 |
| Continuing remission at one year | 160 per 1,000 | 120 per 1,000 (30 to 482) | RR 0.75 (0.19 to 3.01) | 50 (1) | ⊕⊕⊝⊝ LOW 2 3 |
| Adverse events: renal insufficiency | 120 per 1,000 | 40 per 1,000 (5 to 359) | RR 0.33 (0.04 to 2.99) | 50 (1) | ⊕⊕⊝⊝ LOW 2 3 |
| Adverse events: bacterial infection | 103 per 1,000 | 106 per 1,000 (10 to 1,000) | RR 1.02 (0.10 to 10.62) | 61 (2) | ⊕⊝⊝⊝ VERY LOW 1 2 3 |
| Adverse events: vomiting | 34 per 1,000 | 82 per 1,000 (12 to 558) | RR 2.38 (0.35 to 16.17) | 61 (2) | ⊕⊝⊝⊝ VERY LOW 1 2 3 |
| Adverse events: alopecia | 80 per 1,000 | 120 per 1,000 (22 to 658) | RR 1.50 (0.27 to 8.22) | 50 (1) | ⊕⊕⊝⊝ LOW 2 3 |
| *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 One study had unclear sequence generation and allocation concealment and significant attrition
2 Small numbers of enrolled patients
3 Small numbers of events