Summary of findings 4. Target of rapamycin inhibitors (TOR‐I) versus antimetabolites: secondary outcomes for primary immunosuppression in kidney transplant recipients.
| TOR‐I compared to antimetabolites: outcomes to 2 years (secondary outcomes) for primary immunosuppression in kidney transplant recipients | |||||
| Patient or population: primary immunosuppression in kidney transplant recipients Setting: kidney transplant units Intervention: TOR‐I Comparison: antimetabolites | |||||
| Outcomes (up to 2 years for secondary outcomes) | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Certainty of the evidence (GRADE) | |
| Risk with antimetabolites | Risk with TOR‐I | ||||
| New‐onset diabetes mellitus | 85 per 1,000 | 103 per 1,000 (86 to 124) | RR 1.28, (1.07 to 1.54) | 8728 (23) | ⊕⊕⊕⊝ MODERATE 1 |
| BK virus infection | 84 per 1,000 | 52 per 1,000 (42 to 64) | RR 0.62 (0.50 to 0.76) | 5152 (12) | ⊕⊕⊕⊕ HIGH |
| GFR (mL/min) | The mean GFR was 2.89 mL/min lower with TOR‐I (4.91 lower to 0.88 lower) than with antimetabolites | ‐‐ | 7099 (25) | ⊕⊕⊕⊝ MODERATE 2 | |
| Hypercholesterolaemia | 102 per 1,000 | 187 per 1,000 (151 to 229) | RR 1.83 (1.48 to 2.25) | 5725 (12) | ⊕⊕⊝⊝ LOW 1 2 |
| Hypertriglyceridaemia | 143 per 1,000 | 212 per 1,000 (180 to 249) | RR 1.48 (1.26 to 1.74) | 4698 (9) | ⊕⊕⊕⊝ MODERATE1 |
| Leucopenia | 123 per 1,000 | 50 per 1,000 (38 to 65) | RR 0.43 (0.33 to 0.56) | 8396 (15) | ⊕⊕⊝⊝ LOW 1 2 |
| Thrombocytopenia | 33 per 1,000 | 65 per 1,000 (46 to 92) | RR 1.96 (1.38 to 2.79) | 5028 (8) | ⊕⊕⊝⊝ LOW 1 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; GFR: glomerular filtration rate | |||||
| 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 Funnel plot shows few studies reporting participants without events suggesting publication bias
2 Significant heterogeneity between studies
3 Few events with wide confidence intervals