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What do systematic reviews say?

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Evidence found and GRADE certainty

64 questions · 68 findings · 6 reviews

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No studies found 10 · 14.7%GRADE not reported 2 · 2.9%Very low 15 · 22.1%Low 16 · 23.5%Moderate 23 · 33.8%High 2 · 2.9%

Summary of findings: oral steroids plus antibiotic vs control plus antibiotic

Adverse effects [2 weeks to 6 months] · Children with otitis media with effusion

Summary of findings: oral steroids plus antibiotic showed no clear difference in adverse effects [2 weeks to 6 months] compared with control plus antibiotic (low certainty).

1 finding from 1 review

Summary of findings: oral steroids plus antibiotic vs control plus antibiotic

Hearing loss · Children with otitis media with effusion

Summary of findings: oral steroids plus antibiotic showed no clear difference in hearing loss [2 months]1 compared with control plus antibiotic (moderate certainty).

1 finding from 1 review

Summary of findings: oral steroids plus antibiotic vs control plus antibiotic

OME resolution at short‐term · Children with otitis media with effusion

Summary of findings: oral steroids plus antibiotic leads to higher OME resolution at short‐term compared with control plus antibiotic (high certainty).

1 finding from 1 review

Oral corticosteroids vs placebo or NSAID

Proportion of patients with resolution or improved symptoms at days 3 to 7 · patients with acute sinusitis

Oral corticosteroids probably leads to higher proportion of patients with resolution or improved symptoms at days… compared with placebo or NSAID (moderate certainty).

3 findings from 1 review

Oral corticosteroids vs placebo or NSAID

Proportion of patients with resolution or improved symptoms at days 4 to 14 · patients with acute sinusitis

Oral corticosteroids probably leads to higher proportion of patients with resolution or improved symptoms at days… compared with placebo or NSAID (moderate certainty).

2 findings from 1 review

Oral corticosteroids vs placebo or NSAID

Proportion of patients with resolution or improved symptoms at days 4 to 14 ‐ Co‐treatment with antibiotics · patients with acute sinusitis

Oral corticosteroids may leads to higher proportion of patients with resolution or improved symptoms at days… compared with placebo or NSAID (low certainty).

1 finding from 1 review

Oral alkylating agents ± steroids vs steroids or placebo or both, or no treatment

Death at final · primary membranous nephropathy in adults with nephrotic syndrome

Oral alkylating agents ± steroids showed no clear difference in death at final compared with placebo/no treatment/steroids (low certainty).

1 finding from 1 review

Oral alkylating agents ± steroids vs steroids or placebo or both, or no treatment

End‐stage renal disease · primary membranous nephropathy in adults with nephrotic syndrome

Oral alkylating agents ± steroids probably leads to lower end‐stage kidney disease at final compared with placebo/no treatment/steroids (moderate certainty).

1 finding from 1 review

Oral alkylating agents ± steroids vs steroids or placebo or both, or no treatment

Total remission (complete or partial) at final · primary membranous nephropathy in adults with nephrotic syndrome

Oral alkylating agents ± steroids probably leads to higher total remission (complete or partial) at final compared with placebo/no treatment/steroids (moderate certainty).

1 finding from 1 review

Oral alkylating agents ± steroids vs steroids or placebo or both, or no treatment

Complete remission · primary membranous nephropathy in adults with nephrotic syndrome

Oral alkylating agents ± steroids probably leads to higher complete remission at final compared with placebo/no treatment/steroids (moderate certainty).

1 finding from 1 review

Oral alkylating agents ± steroids vs steroids or placebo or both, or no treatment

Relapse · primary membranous nephropathy in adults with nephrotic syndrome

It is very uncertain whether oral alkylating agents ± steroids changes recurrence of disease (relapse) at final compared with placebo/no treatment/steroids (very low certainty).

1 finding from 1 review

Oral alkylating agents ± steroids vs steroids or placebo or both, or no treatment

100% increase in SCr at final · primary membranous nephropathy in adults with nephrotic syndrome

Oral alkylating agents ± steroids showed no clear difference in 100% increase in serum creatinine at final compared with placebo/no treatment/steroids (moderate certainty).

1 finding from 1 review

Oral alkylating agents ± steroids vs steroids or placebo or both, or no treatment

Adverse events ‐ temporary or permanent discontinuation/hospitalisation at final · primary membranous nephropathy in adults with nephrotic syndrome

Oral alkylating agents ± steroids may leads to higher adverse events ‐ temporary/permanent discontinuation or… compared with placebo/no treatment/steroids (low certainty).

1 finding from 1 review

Oral alkylating agents ± steroids vs steroids or placebo or both, or no treatment

Adverse events ‐ infection at 3 years · primary membranous nephropathy in adults with nephrotic syndrome

It is very uncertain whether oral alkylating agents ± steroids changes adverse events ‐ infection at 3 years compared with placebo/no treatment/steroids (very low certainty).

1 finding from 1 review

Oral alkylating agents ± steroids vs steroids or placebo or both, or no treatment

Adverse events: malignancy · primary membranous nephropathy in adults with nephrotic syndrome

It is very uncertain whether oral alkylating agents ± steroids changes adverse events ‐ malignancy at final compared with placebo/no treatment/steroids (very low certainty).

1 finding from 1 review