Xie 2011.

Methods	Study design: parallel, 3‐arm RCT Time frame: June 2009 to June 2012 Duration of follow‐up: 12 months
Participants	Setting: multicentre (8 sites) Country: China Inclusion criteria: pathologically diagnosed primary IgAN by renal biopsy; mean urinary protein excretion on 2 measurements within 1 week of 0.5 to 3.5 g/24 hours; mean SCr level on 2 measurements within 1 week of 353.6 mol/L; age of 14 to 70 years regardless of sex; and lack of use of steroids, immunosuppressants, ACEi and ARB drug within the 3‐month period preceding the study Number (analysed/randomised): treatment group 1 (25/30); treatment group 2 (29/35); control group (30/34) Mean age ± SD (years): treatment group 1 (33.67 ± 11.62); treatment group 2 (33.63 ± 11.71); control group (33.68 ± 10.29) Sex (M/F): treatment group 1 (14/16); treatment group 2 (14/21); control group (14/20) Exclusion criteria: sensitivity to mizoribine or losartan; leukocyte count 3000/mm3; pregnant or desiring to be pregnant; and secondary IgAN (SLE, hypersensitive purpura, type B hepatitis, cirrhosis, etc)
Interventions	Treatment group 1 Different doses of mizoribine were administered orally according to body weight and SCr level Body weight < 50 kg: 200 mg/day (100 mg in the morning and 100 mg in the afternoon) Body weight ≥ 50 kg: 250 mg/day (150 mg in the morning and 100 mg in the afternoon) SCr > 176.8 mol/L, 150 mg/day (100 mg in the morning and 50 mg in the afternoon) Treatment group 2 Losartan (oral): administered every morning as losartan potassium (100 mg/day) Control group In the combination group, the doses and timing of administration were the same as in the losartan and mizoribine groups Co‐interventions Calcium antagonists, beta‐receptor blockers or alfa‐receptor blockers could be used for patients with hypertension in the losartan group and the combination group whose BP was higher than 130/80 mmHg despite oral administration of losartan 100 mg; in addition, the same drugs could be used for patients with hypertension in the mizoribine group. The target BP was 130/80 mmHg. The use of steroids, immunosuppressants other than mizoribine, ACEi and ARB other than losartan was excluded
Outcomes	24‐hour urinary protein excretion SCr eGFR Serum uric acid BP Adverse events
Notes	The protocol was registered with the Cochrane Renal Prospective Trial Registry in 2006 and also with the Australian and New Zealand Clinical Trial Registration Centre in 2009 This study was supported by the Key Program of the National Natural Science Foundation of China (Grant No.30630033), National Key Technologies R&D Program of China (Grant No. 2007BAI04B10) and Science and Technology Project of Beijing, China (Grant No. D09050704310904)
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Insufficient information to permit judgement
Allocation concealment (selection bias)	Unclear risk	Insufficient information to permit judgement
Blinding of participants and personnel (performance bias) All outcomes	High risk	Open‐label study
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Blinding of outcome assessment not specifically reported. Key outcomes were objective laboratory measures and were unlikely to be affected by any knowledge of treatment allocation
Incomplete outcome data (attrition bias) All outcomes	High risk	6/35 participants in mizoribine group did not complete study. 4/34 participants in combination group did not complete study. 5/30 participants in the losartan group did not complete study
Selective reporting (reporting bias)	High risk	Key outcomes expected for this type of study (death (any cause), ESKD) were not reported
Other bias	Low risk	The study appeared to be free of other source of bias