Summary of findings 5. Mizoribine regimen versus no mizoribine regimen for IgA nephropathy.
| Mizoribine regimen compared with no mizoribine regimen for IgA nephropathy | |||||
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Patient or population: adults and children who have IgA nephropathy proven on renal biopsy Settings: Japan Intervention: mizoribine regimen (includes mizoribine alone or with RAS inhibitors) Comparison: no mizoribine regimen | |||||
| Outcomes | Anticipated absolute benefits* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Quality of the evidence (GRADE) | |
| Risk without mizoribine | Risk with mizoribine | ||||
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End‐stage kidney disease Follow‐up: 3 years |
48 per 1000 | 48 per 1000 (3 to 718) |
RR 1.00 (0.07 to 14.95) |
42 (1) | ⊕⊝⊝⊝ very low 1,2 |
|
Complete remission Follow‐up: 3 years |
467 per 1000 | 887 per 1000 (495 to 1000) |
RR 1.90 (1.06 to 3.43) |
24 (1) | ⊕⊝⊝⊝ very low 1,2 |
| GFR loss ≥ 50% | No data observations | Not estimable | No studies | No studies | Not estimable |
|
Annual GFR loss (mL/min/1.73 m2) |
No data observations | Not estimable | No studies | No studies | Not estimable |
| Death (any cause) | No data observations | Not estimable | No studies | No studies | Not estimable |
|
Infection Follow‐up: 1 to 2.1 years |
60 per 1000 | 91 per 1000 (8 to 969) |
RR 1.52 (0.14 to 16.15) |
104 (2) | ⊕⊝⊝⊝ very low 1,2,3 |
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Malignancy Follow‐up: 3 years |
No events | 1/21** | RR 3.00 (0.13 to 69.70) |
42 (1) | ⊕⊝⊝⊝ very low 1,2 |
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The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). The corresponding risk (and its 95% confidence interval) 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. ** Event rate derived from the raw data. A 'per thousand' rate is non‐informative in view of the scarcity of evidence and zero events in the control group | |||||
| 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 Downgraded due to study limitations including lack of allocation concealment and lack of blinding
2 Downgraded two levels due to severe imprecision in treatment estimate (consistent with appreciable benefit or harm)
3 Downgraded due to evidence of important statistical heterogeneity