Cochrane · systematic review · CD002922
Immunosuppressive treatment for proliferative lupus nephritis
Tunnicliffe, DJ, Palmer, SC, Henderson, L, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
18
current version
GRADE rated
18
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 5 · 27.8%Low 10 · 55.6%Moderate 3 · 16.7%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyMycophenolate mofetil (MMF) versus IV cyclophosphamide (CPA) for induction therapy
Population: patients with induction therapy in lupus nephritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death Mycophenolate mofetil (MMF) vs IV cyclophosphamide (CPA) | RR 1.12 [0.61, 2.06] | 8 studies · 826 participants | Very low |
ESKD Mycophenolate mofetil (MMF) vs IV cyclophosphamide (CPA) | RR 0.71 [0.27, 1.84] | 3 studies · 231 participants | Very low |
Complete renal remission Mycophenolate mofetil (MMF) vs IV cyclophosphamide (CPA) | RR 1.17 [0.97, 1.42] | 8 studies · 828 participants | Low |
Partial renal remission Mycophenolate mofetil (MMF) vs IV cyclophosphamide (CPA) | RR 1.02 [0.89, 1.18] | 9 studies · 868 participants | Low |
Ovarian failure Mycophenolate mofetil (MMF) vs IV cyclophosphamide (CPA) | RR 0.36 [0.06, 2.18] | 3 studies · 539 participants | Very low |
Major infection Mycophenolate mofetil (MMF) vs IV cyclophosphamide (CPA) | RR 1.02 [0.67, 1.54] | 6 studies · 699 participants | Low |
Alopecia Mycophenolate mofetil (MMF) vs IV cyclophosphamide (CPA) | RR 0.29 [0.19, 0.46] | 3 studies · 622 participants | Moderate |
Diarrhoea Mycophenolate mofetil (MMF) vs IV cyclophosphamide (CPA) | RR 2.42 [1.64, 3.58] | 4 studies · 609 participants | Moderate |
Mycophenolate mofetil (MMF) + tacrolimus (TAC) versus IV cyclophosphamide (CPA) for induction therapy
Population: Patients with proliferative lupus nephritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete renal remission Mycophenolate mofetil (MMF) + tacrolimus (TAC) vs IV cyclophosphamide (CPA) | RR 2.38 [1.07, 5.3] | 2 studies · 402 participants | Low |
Partial renal remission Mycophenolate mofetil (MMF) + tacrolimus (TAC) vs IV cyclophosphamide (CPA) | RR 1 [0.78, 1.28] | 2 studies · 402 participants | Low |
Stable kidney function Mycophenolate mofetil (MMF) + tacrolimus (TAC) vs IV cyclophosphamide (CPA) | RR 1.78 [1.4, 2.26] | 2 studies · 402 participants | Low |
Azathioprine (AZA) versus mycophenolate mofetil (MMF) for maintenance therapy
Population: patients with maintenance treatment in lupus nephritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death Azathioprine (AZA) vs mycophenolate mofetil (MMF) | RR 1.15 [0.34, 3.87] | 4 studies · 451 participants | Very low |
ESKD Azathioprine (AZA) vs mycophenolate mofetil (MMF) | RR 1.7 [0.52, 5.54] | 4 studies · 452 participants | Very low |
Renal relapse Azathioprine (AZA) vs mycophenolate mofetil (MMF) | RR 1.75 [1.2, 2.55] | 4 studies · 452 participants | Moderate |
Doubling of serum creatinine Azathioprine (AZA) vs mycophenolate mofetil (MMF) | RR 2.19 [1.03, 4.66] | 4 studies · 452 participants | Low |
Major infection Azathioprine (AZA) vs mycophenolate mofetil (MMF) | RR 1.08 [0.69, 1.96] | 3 studies · 412 participants | Low |
Leucopenia Azathioprine (AZA) vs mycophenolate mofetil (MMF) | RR 5.61 [1.68, 18.72] | 3 studies · 412 participants | Low |
Alopecia Azathioprine (AZA) vs mycophenolate mofetil (MMF) | RR 0.95 [0.46, 1.95] | 3 studies · 412 participants | Low |
MMF versus IV cyclophosphamide for induction therapy
Population: Patients with induction therapy in lupus nephritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality MMF vs IV cyclophosphamide | RR 1.02 [0.52, 1.98] | 7 studies · 710 participants | Moderate |
Complete renal remission MMF vs IV cyclophosphamide | RR 1.39 [0.99, 1.95] | 6 studies · 686 participants | Moderate |
Alopecia MMF vs IV cyclophosphamide | RR 0.22 [0.06, 0.86] | 2 studies · 522 participants | Low |
Major infection MMF vs IV cyclophosphamide | RR 1.11 [0.74, 1.68] | 6 studies · 683 participants | Moderate |
Ovarian failure MMF vs IV cyclophosphamide | RR 0.15 [0.03, 0.8] | 2 studies · 498 participants | High |
Leucopenia MMF vs IV cyclophosphamide | RR 0.48 [0.25, 0.91] | 5 studies · 613 participants | High |
Diarrhoea MMF vs IV cyclophosphamide | RR 2.53 [1.54, 4.16] | 3 studies · 569 participants | High |
Azathioprine versus MMF for maintenance therapy
Population: Patients with maintenance treatment in lupus nephritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality Azathioprine vs MMF | RR 0.58 [0.1, 3.49] | 3 studies · 371 participants | Moderate |
Renal relapse Azathioprine vs MMF | RR 1.83 [1.24, 2.71] | 3 studies · 371 participants | Moderate Downgraded: imprecision |
Major infection Azathioprine vs MMF | RR 0.87 [0.31, 2.43] | 1 study · 105 participants | Moderate Downgraded: imprecision |
Malignancy Azathioprine vs MMF | RR 4.04 [0.45, 36.07] | 3 studies · 370 participants | High |
Leucopenia Azathioprine vs MMF | RR 6.21 [1.69, 22.85] | 2 studies · 331 participants | High |
GI disturbance Azathioprine vs MMF | RR 1.02 [0.41, 2.51] | 1 study · 105 participants | Moderate Downgraded: imprecision |
Alopecia Azathioprine vs MMF | RR 0.51 [0.05, 5.45] | 1 study · 105 participants | Moderate Downgraded: imprecision |