What do systematic reviews say?

Aldosterone antagonists vs placebo or usual care

Aldosterone antagonists (spironolactone or eplerenone) probably leads to lower death (any cause) compared with control (placebo or standard care) (moderate certainty).

• Aldosterone antagonists for people with chronic kidney disease requiring dialysis 2021 · Cochrane Headline outcomes only
  RR 0.45 [0.3, 0.67]
  9 studies · 1119 participants
  Moderate

Aldosterone antagonists vs placebo or usual care

Aldosterone antagonists (spironolactone or eplerenone) probably leads to lower death (cardiovascular) compared with control (placebo or standard care) (moderate certainty).

• Aldosterone antagonists for people with chronic kidney disease requiring dialysis 2021 · Cochrane Headline outcomes only
  RR 0.37 [0.22, 0.64]
  6 studies · 908 participants
  Moderate

Aldosterone antagonists vs placebo or usual care

Aldosterone antagonists (spironolactone or eplerenone) probably leads to lower cardiovascular and cerebrovascular morbidity compared with control (placebo or standard care) (moderate certainty).

• Aldosterone antagonists for people with chronic kidney disease requiring dialysis 2021 · Cochrane Headline outcomes only
  RR 0.38 [0.18, 0.76]
  3 studies · 328 participants
  Moderate

Aldosterone antagonists vs placebo or usual care

Aldosterone antagonists (spironolactone or eplerenone) showed no clear difference in hyperkalaemia compared with control (placebo or standard care) (low certainty).

• Aldosterone antagonists for people with chronic kidney disease requiring dialysis 2021 · Cochrane Headline outcomes only
  RR 1.41 [0.72, 2.78]
  9 studies · 981 participants
  Low

Aldosterone antagonists vs placebo or usual care

Aldosterone antagonists (spironolactone or eplerenone) probably leads to higher gynaecomastia compared with control (placebo or standard care) (moderate certainty).

• Aldosterone antagonists for people with chronic kidney disease requiring dialysis 2021 · Cochrane Headline outcomes only
  RR 5.95 [1.93, 18.28]
  4 studies · 768 participants
  Moderate

Aldosterone antagonists vs placebo or usual care

• Aldosterone antagonists for people with chronic kidney disease requiring dialysis 2021 · Cochrane Headline outcomes only
  no estimate extracted
  7 studies · 562 participants
  Low

Rituximab vs placebo or control

Rituximab probably leads to lower relapses at 3 months compared with placebo or control (moderate certainty).

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  RR 0.32 [0.14, 0.7]
  3 studies · 132 participants
  Moderate

Rituximab vs placebo or control

Rituximab probably leads to lower relapses at 6 months compared with placebo or control (moderate certainty).

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  RR 0.23 [0.12, 0.43]
  5 studies · 269 participants
  Moderate
• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  RR 0.63 [0.42, 0.93]
  3 studies · 198 participants
  Moderate

Levamisole vs steroids or placebo or both, or no treatment

Levamisole may leads to lower relapse during treatment (4 to 12 months) compared with steroids or placebo or both, or no treatment (low certainty).

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  RR 0.52 [0.33, 0.82]
  8 studies · 474 participants
  Low

Levamisole vs steroids or placebo or both, or no treatment

Levamisole may leads to lower relapse at 6 to 12 months compared with steroids or placebo or both, or no treatment (low certainty).

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  RR 0.65 [0.48, 0.88]
  8 studies · 462 participants
  Low

Levamisole vs steroids or placebo or both, or no treatment

The review found no eligible studies for this question.

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Levamisole vs steroids or placebo or both, or no treatment

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 2 participants
  Very low

Levamisole vs steroids or placebo or both, or no treatment

Levamisole showed no clear difference in adverse effects: leucopenia compared with steroids or placebo or both, or no treatment (low certainty).

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  RR 4.18 [0.72, 24.21]
  3 studies · 214 participants
  Low

Levamisole vs steroids or placebo or both, or no treatment

Levamisole showed no clear difference in adverse effects: ANCA positive/arthritis compared with steroids or placebo or both, or no treatment (low certainty).

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  RR 3 [0.13, 71.92]
  1 study · 100 participants
  Low

Rituximab vs placebo or control

The review found no eligible studies for this question.

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Rituximab vs placebo or control

The review found no eligible studies for this question.

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Alkylating agents vs steroids, placebo or both

Alkylating agents probably leads to lower relapse at 6 to 12 months compared with steroids, placebo or both (moderate certainty).

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  RR 0.44 [0.32, 0.6]
  6 studies · 202 participants
  Moderate
• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  RR 0.2 [0.09, 0.46]
  4 studies · 59 participants
  Low

Alkylating agents vs steroids, placebo or both

The review found no eligible studies for this question.

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Alkylating agents vs steroids, placebo or both

The review found no eligible studies for this question.

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Alkylating agents vs steroids, placebo or both

Alkylating agents led to higher CPA: leucopenia compared with steroids, placebo or both; GRADE not reported.

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  RR 10.63 [1.45, 78.05]
  Studies not reported
  GRADE not reported