What do systematic reviews say?

Intervention not reported

The intervention showed no clear difference in graft loss (censored) (moderate certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 1.09 [0.54, 2.2]
  8 studies · 1385 participants
  Moderate

Intervention not reported

The intervention showed no clear difference in biopsy‐proven acute rejection (moderate certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 0.87 [0.67, 1.13]
  8 studies · 1381 participants
  Moderate

Intervention not reported

The intervention showed no clear difference in CMV infection (moderate certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 1.42 [0.78, 2.6]
  5 studies · 865 participants
  Moderate

Intervention not reported

The intervention showed no clear difference in adverse wound outcomes: all complications (low certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 0.95 [0.53, 1.71]
  3 studies · 291 participants
  Low

Intervention not reported

The intervention showed no clear difference in all malignancies (low certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 1.04 [0.36, 3.04]
  7 studies · 1163 participants
  Low

Target of rapamycin inhibitors (TOR‐I) vs calcineurin inhibitors (CNI): main outcomes

Target of rapamycin inhibitors (TOR‐I) probably leads to higher biopsy‐proven acute rejection compared with calcineurin inhibitors (CNI): main outcomes (moderate certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 1.7 [1.32, 2.19]
  15 studies · 3309 participants
  Moderate

Intervention not reported

The intervention showed no clear difference in number needing to change treatment (low certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 1.18 [0.58, 2.42]
  5 studies · 734 participants
  Low

Intervention not reported

The review found no eligible studies for this question.

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Intervention not reported

The intervention showed no clear difference in new‐onset diabetes mellitus: TAC (low certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 1.79 [0.99, 3.23]
  5 studies · 580 participants
  Low

Intervention not reported

The intervention showed no clear difference in new‐onset diabetes mellitus: CSA (low certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 0.57 [0.27, 1.2]
  3 studies · 606 participants
  Low

Intervention not reported

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  no estimate extracted
  7 studies · 1305 participants
  Low

Intervention not reported

The intervention showed no clear difference in hypercholesterolaemia (moderate certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 0.96 [0.75, 1.22]
  4 studies · 734 participants
  Moderate

Intervention not reported

The intervention showed no clear difference in hypertriglyceridaemia (moderate certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 0.85 [0.73, 1.01]
  4 studies · 734 participants
  Moderate

Intervention not reported

The intervention showed no clear difference in anaemia (moderate certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 0.93 [0.8, 1.08]
  6 studies · 1074 participants
  Moderate

Intervention not reported

The intervention showed no clear difference in leucopenia (moderate certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 0.99 [0.7, 1.4]
  5 studies · 1012 participants
  Moderate

Low vs higher dose target of rapamycin inhibitor (TOR‐ I): secondary outcomes

Low showed no clear difference in death (all causes) compared with higher dose target of rapamycin inhibitor (TOR‐I): primary outcomes (moderate certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 0.89 [0.63, 1.25]
  13 studies · 3894 participants
  Moderate

Target of rapamycin inhibitors (TOR‐I) vs calcineurin inhibitors (CNI): main outcomes

Target of rapamycin inhibitors (TOR‐I) leads to lower CMV infection compared with calcineurin inhibitors (CNI): main outcomes (high certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 0.43 [0.29, 0.63]
  13 studies · 2026 participants
  High

Low vs higher dose target of rapamycin inhibitor (TOR‐ I): secondary outcomes

Low showed no clear difference in total graft loss (with death) compared with higher dose target of rapamycin inhibitor (TOR‐I): primary outcomes (moderate certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 0.84 [0.67, 1.06]
  11 studies · 3476 participants
  Moderate

Low vs higher dose target of rapamycin inhibitor (TOR‐ I): secondary outcomes

Low probably leads to higher biopsy‐proven acute rejection compared with higher dose target of rapamycin inhibitor (TOR‐I): primary outcomes (moderate certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 1.26 [1.1, 1.43]
  11 studies · 3731 participants
  Moderate

Low vs higher dose target of rapamycin inhibitor (TOR‐ I): secondary outcomes

Low showed no clear difference in CMV infection compared with higher dose target of rapamycin inhibitor (TOR‐I): primary outcomes (moderate certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 0.87 [0.63, 1.21]
  9 studies · 3099 participants
  Moderate