Zhu 2008a.

Methods	Study design: parallel RCT Time frame: 2003 to 2005 Follow‐up period: 2 years Primary endpoint: not reported
Participants	Country: China Setting: single centre Cadaveric kidney transplant Number (randomised): 45 total Median age (range): 44 (26 to 65) years Sex (% female): not reported Exclusion criteria: PRA > 10%; multi‐organ transplantation; serious infections (e.g. AIDS); malignancy
Interventions	Treatment group Steroid withdrawal 6 months after transplantation Control group Steroid maintenance Baseline Immunosuppression TAC: day 0 to 14: adjusted to blood levels between 10 to 20 ng/mL; thereafter: 5 to 15 ng/mL MMF: 1.5 to 2.0 g/d Steroids IV methylprednisone: day 0: 500 mg; day 1: 300mg; day 2: 200 mg Oral prednisone: day 3 to 14: 20 mg/d; day 15 to 28: 15 mg/d Withdrawal group: day 29 to 92: tapered to 5 mg/d; withdrawn on day 183 Maintenance group: day 29 to study end: 10 mg/d
Outcomes	Mortality Acute rejection NODAT Infection SCr (µmol/L)
Notes	Did not report number screened for eligibility or analysed
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Stated 'randomised' but no further information provided
Allocation concealment (selection bias)	Unclear risk	Not reported
Blinding (performance bias and detection bias) All outcomes	High risk	Open‐label
Blinding of participants and personnel (performance bias) All outcomes	High risk	Open‐label
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Outcomes are objective hard endpoints
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Number of patients and number of events per group not reported; unclear whether ITT analysis was performed. Number of patients lost to follow up not reported
Selective reporting (reporting bias)	High risk	Graft loss not reported
Other bias	Unclear risk	Funding source not reported It was not reported how many of the participants were randomised to either group, whether the timing of outcome assessment is similar in all groups, whether the groups were similar at baseline, whether co‐interventions were avoided or similar Important information on design and conduct of study not reported

ALG ‐ anti‐lymphocyte globulin; ATG ‐ anti‐thymocyte globulin; AZA ‐ azathioprine; CMV ‐ cytomegalovirus; CNI ‐ calcineurin inhibitor; CrCl ‐ creatinine clearance; CsA ‐ cyclosporin; EC‐MPS ‐ enteric‐coated mycophenolate sodium; eGFR ‐ estimated glomerular filtration rate; EVL ‐ everolimus; GFR ‐ glomerular filtration rate; HBsAG ‐ hepatitis B surface antigen; HCT ‐ haematocrit; HIV ‐ human immunodeficiency virus; HLA ‐ human leukocyte antigen; HTLV‐1 ‐ human T‐lymphotropic virus type 1; IL‐2RA ‐ interleukin 2 receptor antagonist; ITT ‐ intention‐to‐treat analysis; IV ‐ intravenous; MMF ‐ mycophenolate mofetil; NODAT ‐ new‐onset diabetes post transplant; PO ‐ oral; PRA ‐ panel reactive antibodies; PTLD ‐ Post‐transplant lymphoproliferative disease; RCT ‐ randomised controlled trial; SCr ‐ serum creatinine; SD ‐ standard deviation; SRL ‐ sirolimus; TAC ‐ tacrolimus; WCC ‐ white cell count