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. 2020 Jan 13;2020(1):CD003232. doi: 10.1002/14651858.CD003232.pub4

Jayne 2000.

Methods
  • Study design: parallel RCT

  • Duration of study: not reported

  • Duration of follow‐up: 12 months

Participants
  • Country: UK

  • Setting: multicentre (5)

  • Inclusion criteria: prior diagnosis of WG or MPA; ANCA positivity at diagnosis; active vasculitis with a requirement for further therapy; at least 2 months treatment with prednisolone and CPA or AZA; ≥ 18 years

  • Number: treatment group (17); control group (17)

  • Mean age ± SD (years): treatment group (57.1 ± 10.5); control group (50.4 ± 19.9)

  • Sex (M/F): treatment group (10/7); control group (9/8)

  • Exclusion criteria: IVIg in previous 3 months; history of anaphylaxis to matched blood products; selective IgA deficiency; RPGN (20% rise in SCr in 2 weeks) or pulmonary haemorrhage

Interventions Initial treatment (both groups)
  • CPA and prednisolone for remission induction then AZA for maintenance then a 2‐week observation period


Treatment group
  • IVIg: 0.4 g/kg/day for 5 days


Control group
  • Placebo (identical injections) for 5 days

Outcomes Primary outcome
  • Treatment response. BVAS reduction of 50% between entry and 3 months


Secondary outcomes
  • Fall in BVAS, CRP and ANCA

  • Relapse at 3 months

  • Reduction in immunosuppressive drug doses

  • Adverse effects

Notes
  • Funding source: "This trial was supported by a grant and provision of trial medication from Novartis Pharmaceuticals UK."

Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk "Randomisation and distribution of trial medication was centrally controlled by Novartis UK"
Allocation concealment (selection bias) Low risk Medication distributed by Novartis UK
Blinding of participants and personnel (performance bias) 
 All outcomes Low risk "patients and physicians were blinded to the treatment limb"
Blinding of outcome assessment (detection bias) 
 All outcomes Unclear risk Insufficient information to permit judgement
Incomplete outcome data (attrition bias) 
 All outcomes Low risk All patients accounted for
Selective reporting (reporting bias) Low risk Study and review outcomes reported
Other bias High risk Funding source: Novartis