Summary of findings 2. Steroid avoidance versus steroid maintenance for kidney transplant recipients.
| Steroid avoidance versus steroid maintenance for kidney transplant recipients | ||||||
| Patient or population: kidney transplant recipients Intervention: steroid avoidance Comparison: steroid maintenance | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Steroid avoidance versus steroid maintenance | |||||
| Mortality Follow‐up: 1 year | 31 per 1000 | 30 per 1000 (16 to 56) | RR 0.96 (0.52 to 1.8) | 1462 (10) | ⊕⊕⊝⊝ low1,2 | |
| Graft loss (excluding death) Follow‐up: 1 year | 42 per 1000 | 46 per 1000 (27 to 79) | RR 1.09 (0.64 to 1.86) | 1211 (7) | ⊕⊕⊝⊝ low2,3 | |
| Acute rejection Follow‐up: 1 year | 204 per 1000 | 323 per 1000 (221 to 470) | RR 1.58 (1.08 to 2.3) | 835 (7) | ⊕⊕⊕⊝ moderate4 | |
| NODAT Follow‐up: 5 years | 107 per 1000 | 80 per 1000 (54 to 117) | RR 0.75 (0.51 to 1.1) | 1618 (9) | ⊕⊕⊝⊝ low2,5 | |
| CMV Infection Follow‐up: 5 years | 106 per 1000 | 101 per 1000 (74 to 138) | RR 0.96 (0.7 to 1.31) | 1454 (6) | ⊕⊕⊝⊝ low2,6 | |
| *The assumed risk is the baseline risk in the control group treated with steroid maintenance. 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; NODAT: new‐onset diabetes after transplantation; CMV ‐ cytomegalovirus | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate | ||||||
1 All studies were unblinded. Six studies were industry sponsored. In six studies random sequence generation or allocation concealment or both was unclear. In two studies ITT was either not performed or unclear. One study had selective outcome reporting 2 Total number of events was fewer than 300 3 All studies were unblinded. Five studies were industry sponsored. In four studies random sequence generation or allocation concealment or both was unclear. ITT was unclear in one study. One study had selective outcome reporting 4 All studies were unblinded. Five studies were industry sponsored. In four studies random sequence generation or allocation concealment or both was unclear. In three studies ITT was either not performed or unclear. One study had selective outcome reporting 5 Most studies were unblinded (8 studies). Five studies were industry sponsored. In four studies random sequence generation or allocation concealment or both was unclear. One study had selective outcome reporting 6 Most studies were unblinded (5 studies). Four studies were industry sponsored. One study had unclear ITT