Comparison 2. Steroid avoidance versus steroid maintenance.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Death and graft loss	13		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
1.1 Death up to one year	10	1462	Risk Ratio (M‐H, Random, 95% CI)	0.96 [0.52, 1.80]
1.2 Death one to five years	7	1201	Risk Ratio (M‐H, Random, 95% CI)	0.57 [0.32, 1.01]
1.3 Graft loss including death up to one year	7	1211	Risk Ratio (M‐H, Random, 95% CI)	1.08 [0.72, 1.62]
1.4 Graft loss including death one to five years	7	1245	Risk Ratio (M‐H, Random, 95% CI)	0.79 [0.53, 1.18]
1.5 Graft loss excluding death up to one year	7	1211	Risk Ratio (M‐H, Random, 95% CI)	1.09 [0.64, 1.86]
1.6 Graft loss excluding death one to five years	7	1245	Risk Ratio (M‐H, Random, 95% CI)	0.98 [0.66, 1.45]
2 Rejection	9		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
2.1 Acute rejection up to one year	7	835	Risk Ratio (M‐H, Random, 95% CI)	1.58 [1.08, 2.30]
2.2 Biopsy‐proven acute rejection up to one year	6	1073	Risk Ratio (M‐H, Random, 95% CI)	1.94 [1.26, 2.98]
3 New‐onset diabetes after transplantation and cardiovascular events	9		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
3.1 New onset diabetes after transplantation up to five years	9	1618	Risk Ratio (M‐H, Random, 95% CI)	0.75 [0.51, 1.10]
3.2 Cardiovascular events up to five years	4	1013	Risk Ratio (M‐H, Random, 95% CI)	0.56 [0.30, 1.05]
4 Infection and malignancy	11		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
4.1 Infection (all) up to five years	9	1833	Risk Ratio (M‐H, Random, 95% CI)	0.93 [0.84, 1.03]
4.2 CMV Infection up to five years	6	1454	Risk Ratio (M‐H, Random, 95% CI)	0.96 [0.70, 1.31]
4.3 Malignancy up to five years	7	1635	Risk Ratio (M‐H, Random, 95% CI)	0.97 [0.61, 1.52]
5 Kidney function	10		Std. Mean Difference (IV, Random, 95% CI)	Subtotals only
5.1 Serum creatinine (mg/dL) up to one year	5	735	Std. Mean Difference (IV, Random, 95% CI)	0.02 [‐0.12, 0.17]
5.2 Serum creatinine (mg/dL) one to five years	3	688	Std. Mean Difference (IV, Random, 95% CI)	‐0.01 [‐0.16, 0.14]
5.3 Creatinine clearance (mL/min) up to one year	6	1104	Std. Mean Difference (IV, Random, 95% CI)	‐0.08 [‐0.23, 0.08]
5.4 Creatinine clearance (mL/min) one to five years	3	563	Std. Mean Difference (IV, Random, 95% CI)	‐0.08 [‐0.25, 0.08]