What do systematic reviews say?

Calcineurin inhibitors ± steroids vs alkylating agents ± steroids

It is very uncertain whether calcineurin inhibitors ± steroids changes 100% increase in SCr at final compared with alkylating agents ± steroids (very low certainty).

• Immunosuppressive treatment for primary membranous nephropathy in adults with nephrotic syndrome 2021 · Cochrane Headline outcomes only
  RR 0.7 [0.3, 1.67]
  2 studies · 132 participants
  Very low

Calcineurin inhibitors ± steroids vs alkylating agents ± steroids

It is very uncertain whether calcineurin inhibitors ± steroids changes adverse events ‐ temporary or permanent… compared with alkylating agents ± steroids (very low certainty).

• Immunosuppressive treatment for primary membranous nephropathy in adults with nephrotic syndrome 2021 · Cochrane Headline outcomes only
  RR 1.43 [0.31, 6.67]
  3 studies · 151 participants
  Very low

Calcineurin inhibitors ± steroids vs alkylating agents ± steroids

Calcineurin inhibitors ± steroids showed no clear difference in adverse events ‐ infection ( compared with alkylating agents ± steroids (low certainty).

• Immunosuppressive treatment for primary membranous nephropathy in adults with nephrotic syndrome 2021 · Cochrane Headline outcomes only
  RR 0.86 [0.43, 1.71]
  9 studies · 552 participants
  Low

Calcineurin inhibitors ± steroids vs alkylating agents ± steroids

It is very uncertain whether calcineurin inhibitors ± steroids changes adverse events ‐ malignancy (range 30 to 36 months compared with alkylating agents ± steroids (very low certainty).

• Immunosuppressive treatment for primary membranous nephropathy in adults with nephrotic syndrome 2021 · Cochrane Headline outcomes only
  RR 0.18 [0.01, 3.69]
  2 studies · 127 participants
  Very low

Group 1 Pulmonary arterial hypertension ‐ PDE5i vs placebo, on combination therapy

• Phosphodiesterase 5 inhibitors for pulmonary hypertension 2019 · Cochrane Headline outcomes only
  no estimate extracted
  4 studies · 509 participants
  Moderate

Group 1 Pulmonary arterial hypertension ‐ PDE5i vs ERA

• Phosphodiesterase 5 inhibitors for pulmonary hypertension 2019 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 36 participants
  Low

Group 1 Pulmonary arterial hypertension ‐ PDE5i vs placebo

• Phosphodiesterase 5 inhibitors for pulmonary hypertension 2019 · Cochrane Headline outcomes only
  no estimate extracted
  8 studies · 880 participants
  Moderate

Group 2 Pulmonary hypertension due to left‐heart disease ‐ PDE5i vs placebo

• Phosphodiesterase 5 inhibitors for pulmonary hypertension 2019 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 284 participants
  Moderate

Group 3 Pulmonary hypertension due to lung disease ‐ PDE5i vs placebo

• Phosphodiesterase 5 inhibitors for pulmonary hypertension 2019 · Cochrane Headline outcomes only
  no estimate extracted
  5 studies · 350 participants
  High

Group 4 Pulmonary hypertension due to CTEPH ‐ PDE5i vs placebo

• Phosphodiesterase 5 inhibitors for pulmonary hypertension 2019 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 19 participants
  Low
• Phosphodiesterase 5 inhibitors for pulmonary hypertension 2019 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 227 participants
  Moderate

Mixed Pulmonary hypertension group 2 ‐ 4 ‐ PDE5i vs placebo

• Phosphodiesterase 5 inhibitors for pulmonary hypertension 2019 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 106 participants
  Moderate

Intervention not reported

The intervention showed no clear difference in severe adverse events: raised alkaline phosphatase (low certainty).

• Efavirenz or nevirapine in three‐drug combination therapy with two nucleoside or nucleotide‐reverse transcriptase… 2016 · Cochrane Headline outcomes only
  RR 0.65 [0.17, 2.5]
  1 study · 1007 participants
  Low