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. 2016 Aug 22;2016(8):CD005632. doi: 10.1002/14651858.CD005632.pub3

1. Steroid withdrawal versus steroid maintenance ‐ stratified subgroup and sensitivity analysis for death, graft loss and acute rejection up to one year after transplantation.

  Death Graft loss Acute rejection Biopsy‐proven acute rejection
  Studies RR 95% CI Studies RR 95% CI Studies RR 95% CI Studies RR 95% CI
Publication status
Peer reviewed journal 8 0.60 0.31 to 1.17 7 1.25 0.73 to 2.13 8 2.02 1.23 to 3.23 4 1.32 0.66 to 2.66
Abstract only 2 3.04 0.33 to 28.29 1 0.82 0.23 to 2.94 2 1.25 0.67 to 2.32 1 1.37 0.70 to 2.69
ITT analysis
ITT analysis used 6 0.69 0.30 to 1.61 6 1.31 0.69 to 2.46 6 2.07 1.10 to 3.91 3 1.37 0.64 to 2.94
ITT analysis not used/unclear 4 0.67 0.25 to 1.81 2 1.00 0.46 to 2.17 4 1.65 0.81 to 3.36 2 1.04 0.24 to 4.59
Calcineurin inhibitor
CsA 9 0.75 0.36 to 1.54 7 0.90 0.50 to 5.14 9 2.08 1.29 to 3.35 4 1.60 0.87 to 2.92
TAC 1 0.50 0.13 to 1.97 1 2.13 0.88 to 5.14 1 1.11 0.82 to 1.51 1 0.89 0.61 to 1.30
Antimetabolite
MMF or EC‐MPS 6 0.67 0.31 to 1.47 5 1.25 0.75 to 2.08 6 1.41 1.02 to 1.94 3 1.27 0.81 to 2.00
AZA 2 0.93 0.26 to 3.40 2 0.25 0.03 to 2.18 2 2.61 0.62 to 10.91 1 0.33 0.04 to 2.56
MMF or EC‐MPS or AZA 8 0.73 0.38 to 1.43 7 1.15 0.70 to 1.89 8 1.46 1.07 to 1.98 4 1.19 0.75 to 1.90
none 2 0.31 0.03 to 2.95 1 3.00 0.13 to 71.61 2 5.80 2.16 to 15.57 1 9.00 1.19 to 67.93
Induction treatment
Induction (yes) 2 3.00 0.32 to 27.87 1 0.33 0.01 to 8.02 2 0.80 0.22 to 2.91 NA ‐‐ ‐‐
Induction (no) 8 0.60 0.31 to 1.17 7 1.21 0.74 to 1.99 8 1.93 1.26 to 2.94 NA ‐‐ ‐‐

AZA ‐ azathioprine; CI ‐ confidence interval; CsA ‐ cyclosporin A; EC‐MPS ‐ enteric‐coated mycophenolate sodium; ITT ‐ intention to treat; MMF ‐ mycophenolate mofetil; NA ‐ not available; RR ‐ risk ratio; TAC ‐ tacrolimus