Summary of findings 6. Leflunomide regimen versus no leflunomide regimen for IgA nephropathy.
| Leflunomide regimen compared with no leflunomide regimen for IgA nephropathy | |||||
|
Patient or population: adults and children who have IgA nephropathy proven on renal biopsy Settings: China Intervention: leflunomide regimen (includes leflunomide alone or with steroids or RAS inhibitor) Comparison: no leflunomide regimen | |||||
| Outcomes | Anticipated absolute benefits* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Quality of the evidence (GRADE) | |
| Risk without leflunomide | Risk with leflunomide | ||||
|
End‐stage kidney disease Follow‐up: 7.3 years |
111 per 1000 | 76 per 1000 (19 to 294) |
RR 0.68 (0.17 to 2.65) |
85 (1) | ⊕⊝⊝⊝ very low 1,2 |
|
Complete remission Follow‐up: 0.25 to 7.3 years |
357 per 1000 | 386 per 1000 (286 to 521) |
RR 1.08 (0.80 to 1.46) |
282 (4) | ⊕⊝⊝⊝ 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: 0.5 to 7.3 years |
56 per 1000 | 54 per 1000 (25 to 117) |
RR 0.97 (0.45 to 2.09) |
387 (3) | ⊕⊝⊝⊝ very low 1,2 |
| Malignancy | No data observations | Not estimable | No studies | No studies | Not estimable |
| 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. | |||||
| 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)