Endstage renal disease: OR, RR, and RD for all treatment comparisons using the random-effects model. Estimates are derived from random effects, Bayesian network metaanalysis, which treats between-study variance as an informative prior (log normal distribution). The similarity of residual deviance for a random-effects model compared with the fixed-effects model shows the robustness of our finding.
| Treatment | Reference | OR (95% CrI) | RR (95% CrI) | RD % (95% Crl) |
|---|---|---|---|---|
| CYC | CS | 0.49 (0.25–0.92) | 0.56 (0.33–0.93) | −0.12 (−0.22 to −0.01) |
| AZA | 0.60 (0.26–1.36) | 0.67 (0.33–1.26) | −0.09 (−0.21 to 0.06) | |
| MMF | 0.25 (0.06–1.04) | 0.31 (0.08–1.03) | −0.18 (−0.29 to 0.01) | |
| CS HD | 1.74 (0.57–5.34) | 1.45 (0.65–2.63) | 0.12 (−0.10 to 0.39) | |
| CYC HD | 0.27 (0.05–1.24) | 0.34 (0.07–1.17) | −0.17 (−0.29 to 0.04) | |
| CYC + AZA, combined | 0.18 (0.05–0.57) | 0.23 (0.07–0.64) | −0.20 (−0.30 to −0.08) | |
| AZA | CYC | 1.23 (0.58–2.60) | 1.19 (0.63–2.15) | 0.03 (−0.07 to 0.15) |
| MMF | 0.51 (0.12–2.01) | 0.55 (0.14–1.76) | −0.06 (−0.16 to 0.11) | |
| CS HD | 3.59 (1.30–9.86) | 2.56 (1.24–4.58) | 0.24 (0.04–0.48) | |
| CYC HD | 0.57 (0.12–2.42) | 0.61 (0.13–2.01) | −0.06 (−0.16 to 0.14) | |
| CYC + AZA, combined | 0.37 (0.11–1.07) | 0.41 (0.13–1.06) | −0.09 (−0.17 to 0.01) | |
| MMF | AZA | 0.42 (0.11–1.51) | 0.47 (0.13–1.39) | −0.09 (−0.21 to 0.06) |
| CS HD | 2.93 (1.08–8.10) | 2.15 (1.06–4.10) | 0.21 (0.01–0.44) | |
| CYC HD | 0.46 (0.10–1.96) | 0.51 (0.12–1.70) | −0.08 (−0.21 to 0.11) | |
| CYC + AZA, combined | 0.31 (0.09–0.90) | 0.35 (0.11–0.91) | −0.11 (−0.24 to −0.01) | |
| CS HD | MMF | 7.05 (1.66–31.91) | 4.54 (1.45–17.31) | 0.29 (0.08–0.54) |
| CYC HD | 1.10 (0.23–5.44) | 1.09 (0.26–4.50) | 0.01 (−0.14 to 0.19) | |
| CYC + AZA, combined | 0.73 (0.13–3.91) | 0.75 (0.16–3.61) | −0.02 (−0.19 to 0.09) | |
| CYC HD | CS HD | 0.16 (0.03–0.61) | 0.24 (0.06–0.71) | −0.28 (−0.52 to −0.08) |
| CYC + AZA, combined | 0.10 (0.03–0.34) | 0.16 (0.05–0.43) | −0.32 (−0.57 to −0.12) | |
| CYC + AZA, combined | CYC HD | 0.66 (0.11–3.99) | 0.68 (0.14–3.68) | −0.03 (−0.23 to 0.08) |
| Random-effect model | Residual deviance | 38.07 vs 40 data points | ||
| Deviance information criteria | 158.328 | |||
| Fixed-effect model | Residual deviance | 38.38 vs 40 data points | ||
| Deviance information criteria | 157.739 | |||
| Total patients, n | 1343 | |||
| Total studies, n | 40 | |||
| 2-arm, n | 36 | |||
| 3-arm, n | 2 | |||
| 4-arm, n | 2 | |||
HD CS was defined as one of the following: (1) PRED or methylprednisolone 1 gm/m2 QD IV × 3 at entry, and then 1 dose IV Q month for 1 year, and (2) PRED 1 mg/kg PO daily with a slow taper up to 1 year. CS use was defined as one of the following: (1) PRED 40 mg PO QOD for 8 weeks, and then taper to 10 mg QD within a year, and (2) 60 mg QD for 1–3 months reduced to 20 mg/day by 6 months. CYC, SD: IV CYC 0.5–1.0 gm/m2 Q2 month for 1 year or CYC 1–4 mg/kg daily for 3–4 years. HD CYC: IV CYC 0.5–1.0 gm/m2 Q month × 6–9 months, PO and then Q3 months for 0.5–4 years or PO CYC 10 mg/kg daily. HD LEF was LEF at 1 mg/kg QD × 3 days, and then 30 mg QD × 6 months. Significant data are in bold face. RR: relative risk; RD: risk difference; CrI: credible interval; CYC: cyclophosphamide; AZA: azathioprine; MMF: mycophenolate mofetil; CS: corticosteroids; HD: high-dose; PRED: prednisone; QD: once daily; IV: intravenous; Q month: once every month; PO: oral; QOD: every other day; SD: standard dose; Q2: every 2; Q3: every 3; LEF: leflunomide.