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. 2022 Oct 21;2022(10):CD015070. doi: 10.1002/14651858.CD015070.pub2

Comparison 2. Steroids versus CsA.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
2.1 Patient‐reported symptom scores—Bausch: LE alone 6 465 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.33 [‐0.51, ‐0.15]
2.2 Patient‐reported symptom scores—Bausch: LE + CsA 6 462 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.35 [‐0.54, ‐0.17]
2.3 Patient‐reported symptom scores—by regimen 6 531 Std. Mean Difference (IV, Random, 95% CI) ‐0.30 [‐0.48, ‐0.12]
2.3.1 Steroid alone vs. CsA 0.05% 3 172 Std. Mean Difference (IV, Random, 95% CI) ‐0.13 [‐0.43, 0.17]
2.3.2 Steroid run‐in before initiating CsA 0.05% 2 178 Std. Mean Difference (IV, Random, 95% CI) ‐0.21 [‐0.50, 0.09]
2.3.3 Steroid run‐in with CsA 0.05% 2 181 Std. Mean Difference (IV, Random, 95% CI) ‐0.56 [‐0.86, ‐0.27]
2.4 Patient‐reported symptom scores—steroid treatment duration 6 530 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.26 [‐0.43, ‐0.08]
2.4.1 High dose for 3‐4 weeks before tapering 2 106 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.09 [‐0.47, 0.30]
2.4.2 8 weeks 4 355 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.37 [‐0.58, ‐0.16]
2.4.3 12 weeks 1 69 Std. Mean Difference (IV, Fixed, 95% CI) 0.05 [‐0.42, 0.52]
2.5 Tear film break‐up time—Bausch: LE alone 5 353 Mean Difference (IV, Random, 95% CI) 0.37 [‐0.13, 0.87]
2.6 Tear film break‐up time—Bausch: LE + CsA 5 350 Mean Difference (IV, Random, 95% CI) 0.36 [‐0.15, 0.87]
2.7 Tear film break‐up time—by regimen 5   Mean Difference (IV, Random, 95% CI) Subtotals only
2.7.1 Steroid alone 3 172 Mean Difference (IV, Random, 95% CI) 0.28 [‐0.74, 1.30]
2.7.2 Steroid + CsA 3 247 Mean Difference (IV, Random, 95% CI) 0.46 [0.16, 0.76]
2.8 Tear film break‐up time—by steroid treatment duration 5   Mean Difference (IV, Random, 95% CI) Subtotals only
2.8.1 High dose for 2‐4 weeks before tapering 1 66 Mean Difference (IV, Random, 95% CI) 0.09 [‐0.86, 1.04]
2.8.2 Fixed dose for 8 weeks 2 103 Mean Difference (IV, Random, 95% CI) 0.32 [‐1.20, 1.84]
2.8.3 Fixed dose for 3 months 3 250 Mean Difference (IV, Random, 95% CI) 0.47 [0.17, 0.77]
2.9 Corneal fluorescein staining scores—Bausch: LE alone 6 465 Std. Mean Difference (IV, Random, 95% CI) 0.05 [‐0.25, 0.35]
2.10 Corneal fluorescein staining score—Bausch: LE + CsA 6 462 Std. Mean Difference (IV, Random, 95% CI) 0.01 [‐0.27, 0.29]
2.11 Corneal fluorescein staining score—by grading system 6 531 Std. Mean Difference (IV, Random, 95% CI) 0.05 [‐0.20, 0.31]
2.11.1 NEI grading system 4 428 Std. Mean Difference (IV, Random, 95% CI) 0.01 [‐0.31, 0.32]
2.11.2 Other grading system 2 103 Std. Mean Difference (IV, Random, 95% CI) 0.20 [‐0.22, 0.62]
2.12 Corneal fluorescein staining score—by regimen 6   Std. Mean Difference (IV, Random, 95% CI) Subtotals only
2.12.1 Steroid alone vs. CsA 0.05% 3 172 Std. Mean Difference (IV, Random, 95% CI) 0.25 [‐0.06, 0.55]
2.12.2 Steroid run‐in before intitiating CsA 0.05% 2 178 Std. Mean Difference (IV, Random, 95% CI) 0.16 [‐0.14, 0.45]
2.12.3 Steroid run‐in concurrently with CsA 0.05% 2 181 Std. Mean Difference (IV, Random, 95% CI) ‐0.33 [‐0.73, 0.07]
2.13 Corneal fluorescein staining score—by steroid treatment duration 6   Std. Mean Difference (IV, Random, 95% CI) Subtotals only
2.13.1 For 3‐4 weeks 2 107 Std. Mean Difference (IV, Random, 95% CI) 0.06 [‐0.32, 0.44]
2.13.2 For 8 weeks 4 355 Std. Mean Difference (IV, Random, 95% CI) 0.01 [‐0.39, 0.42]
2.13.3 For 12 weeks 1 69 Std. Mean Difference (IV, Random, 95% CI) 0.32 [‐0.15, 0.80]
2.14 Tear osmolarity 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
2.14.1 LE gel 0.5% alone 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
2.14.2 LE gel 0.5% plus CsA 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
2.15 Schirmer's test 4 361 Mean Difference (IV, Random, 95% CI) 1.19 [‐0.40, 2.77]
2.15.1 Steroid alone 1 68 Mean Difference (IV, Random, 95% CI) 0.12 [‐0.59, 0.83]
2.15.2 Combination 3 293 Mean Difference (IV, Random, 95% CI) 1.73 [0.32, 3.13]
2.16 Schirmer's test—by steroid type 4 361 Mean Difference (IV, Random, 95% CI) 1.19 [‐0.40, 2.77]
2.16.1 Ketone steroid: MP + CsA 1 41 Mean Difference (IV, Random, 95% CI) 0.80 [‐0.52, 2.12]
2.16.2 Ester steroid: LE ± CsA 3 320 Mean Difference (IV, Random, 95% CI) 1.32 [‐0.72, 3.36]
2.17 Proportion of participants with increased IOP 4   Risk Ratio (M‐H, Fixed, 95% CI) Totals not selected
2.18 Proportion of participants with any ocular complication 3   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
2.18.1 Steroid alone 2 103 Risk Ratio (M‐H, Random, 95% CI) 0.61 [0.11, 3.43]
2.18.2 Steroid plus CsA 2 110 Risk Ratio (M‐H, Random, 95% CI) 0.65 [0.11, 3.80]