Cochrane · systematic review · CD003965
Immunosuppressive agents for treating IgA nephropathy
Natale, P, Palmer, SC, Ruospo, M, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
Kidney and TransplantAMSTAR 2: not assessed
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
42
current version
GRADE rated
29
No studies
13
Included studies
NR
No studies 13 · 31%Ungraded 0 · 0%Very low 23 · 54.8%Low 4 · 9.5%Moderate 2 · 4.8%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
Systemic corticosteroid versus no corticosteroid regimen for IgA nephropathy
Population: adults and children who have IgA nephropathy proven on renal biopsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
End‐stage kidney disease Systemic corticosteroid vs no corticosteroid regimen | RR 0.39 [0.23, 0.65] | 8 studies · 741 participants | Moderate Downgraded: risk of bias |
Complete remission Systemic corticosteroid vs no corticosteroid regimen | RR 1.76 [1.03, 3.01] | 4 studies · 305 participants | Low Downgraded: risk of bias |
GFR loss ≥ 50% Systemic corticosteroid vs no corticosteroid regimen | RR 0.56 [0.25, 1.24] | 2 studies · 326 participants | Low Downgraded: risk of bias |
Annual GFR loss (mL/min/1.73 m2) Systemic corticosteroid vs no corticosteroid regimen | no estimate extracted | 2 studies · 359 participants | Moderate Downgraded: risk of bias |
Death (any cause) Median Systemic corticosteroid vs no corticosteroid regimen | RR 1.85 [0.17, 20.19] | 1 study · 262 participants | Very low Downgraded: risk of bias |
Infection Median Systemic corticosteroid vs no corticosteroid regimen | RR 21.32 [1.27, 358.1] | 1 study · 262 participants | Very low Downgraded: risk of bias |
Malignancy Systemic corticosteroid vs no corticosteroid regimen | RR 1 [0.06, 15.48] | 1 study · 86 participants | Very low Downgraded: risk of bias |
Cytotoxic regimen versus no cytotoxic regimen for IgA nephropathy
Population: adults and children who have IgA nephropathy proven on renal biopsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
End‐stage kidney disease Cytotoxic regimen vs no cytotoxic regimen | RR 0.63 [0.33, 1.2] | 7 studies · 463 participants | Low Downgraded: risk of bias |
Complete remission Cytotoxic regimen vs no cytotoxic regimen | RR 1.47 [0.94, 2.3] | 5 studies · 381 participants | Very low Downgraded: risk of bias |
GFR loss ≥ 50% Cytotoxic regimen vs no cytotoxic regimen | no estimate extracted | NR | No studies |
Annual GFR loss (mL/min/1.73 m2) Cytotoxic regimen vs no cytotoxic regimen | no estimate extracted | 1 study · 162 participants | Low Downgraded: risk of bias |
Death (any cause) Cytotoxic regimen vs no cytotoxic regimen | RR 0.98 [0.06, 15.33] | 1 study · 162 participants | Very low Downgraded: risk of bias |
Infection Cytotoxic regimen vs no cytotoxic regimen | RR 1.7 | 4 studies · 268 participants | Very low Downgraded: risk of bias |
Malignancy Cytotoxic regimen vs no cytotoxic regimen | RR 4.88 [0.24, 100.08] | 1 study · 162 participants | Very low Downgraded: risk of bias |
MMF regimen versus no MMF regimen for IgA nephropathy
Population: adults and children who have IgA nephropathy proven on renal biopsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
End‐stage kidney disease MMF regimen vs no MMF regimen | RR 0.73 [0.16, 3.23] | 4 studies · 280 participants | Very low Downgraded: risk of bias |
Complete remission MMF regimen vs no MMF regimen | RR 1.05 [0.73, 1.52] | 4 studies · 271 participants | Very low Downgraded: risk of bias |
GFR loss ≥ 50% MMF regimen vs no MMF regimen | RR 2.21 [0.5, 9.74] | 1 study · 32 participants | Very low Downgraded: risk of bias |
Annual GFR loss (mL/min/1.73 m2) MMF regimen vs no MMF regimen | no estimate extracted | 1 study · 28 participants | Very low Downgraded: risk of bias |
Death (any cause) MMF regimen vs no MMF regimen | no estimate extracted | NR | No studies |
Infection MMF regimen vs no MMF regimen | RR 1.36 [0.87, 2.12] | 4 studies · 301 participants | Very low Downgraded: risk of bias |
Malignancy MMF regimen vs no MMF regimen | RR 0.28 [0.03, 2.54] | 2 studies · 86 participants | Very low Downgraded: risk of bias |
Calcineurin inhibitor regimen versus no calcineurin inhibitor regimen for IgA nephropathy
Population: adults and children who have IgA nephropathy proven on renal biopsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
End‐stage kidney disease Calcineurin inhibitor regimen vs no calcineurin inhibitor regimen | no estimate extracted | NR | No studies |
Complete remission Calcineurin inhibitor regimen vs no calcineurin inhibitor regimen | RR 0.91 [0.6, 1.39] | 2 studies · 72 participants | Very low Downgraded: risk of bias |
GFR loss ≥ 50% Calcineurin inhibitor regimen vs no calcineurin inhibitor regimen | no estimate extracted | NR | No studies |
Annual GFR loss (mL/min/ 1.73 m2) Calcineurin inhibitor regimen vs no calcineurin inhibitor regimen | no estimate extracted | NR | No studies |
Death (any cause) Calcineurin inhibitor regimen vs no calcineurin inhibitor regimen | no estimate extracted | NR | No studies |
Infection Calcineurin inhibitor regimen vs no calcineurin inhibitor regimen | RR 0.31 [0.03, 2.74] | 1 study · 48 participants | Very low Downgraded: risk of bias |
Malignancy Calcineurin inhibitor regimen vs no calcineurin inhibitor regimen | RR 0.36 [0.02, 8.45] | 1 study · 48 participants | Very low Downgraded: risk of bias |
Mizoribine regimen versus no mizoribine regimen for IgA nephropathy
Population: adults and children who have IgA nephropathy proven on renal biopsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
End‐stage kidney disease Mizoribine regimen vs no mizoribine regimen | RR 1 [0.07, 14.95] | 1 study · 42 participants | Very low Downgraded: risk of bias |
Complete remission Mizoribine regimen vs no mizoribine regimen | RR 1.9 [1.06, 3.43] | 1 study · 24 participants | Very low Downgraded: risk of bias |
GFR loss ≥ 50% Mizoribine regimen vs no mizoribine regimen | no estimate extracted | NR | No studies |
Annual GFR loss (mL/min/1.73 m2) Mizoribine regimen vs no mizoribine regimen | no estimate extracted | NR | No studies |
Death (any cause) Mizoribine regimen vs no mizoribine regimen | no estimate extracted | NR | No studies |
Infection Mizoribine regimen vs no mizoribine regimen | RR 1.52 [0.14, 16.15] | 2 studies · 104 participants | Very low Downgraded: risk of bias |
Malignancy Mizoribine regimen vs no mizoribine regimen | RR 3 [0.13, 69.7] | 1 study · 42 participants | Very low Downgraded: risk of bias |
Leflunomide regimen versus no leflunomide regimen for IgA nephropathy
Population: adults and children who have IgA nephropathy proven on renal biopsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
End‐stage kidney disease Leflunomide regimen vs no leflunomide regimen | RR 0.68 [0.17, 2.65] | 1 study · 85 participants | Very low Downgraded: risk of bias |
Complete remission Leflunomide regimen vs no leflunomide regimen | RR 1.08 [0.8, 1.46] | 4 studies · 282 participants | Very low Downgraded: risk of bias |
GFR loss ≥ 50% Leflunomide regimen vs no leflunomide regimen | no estimate extracted | NR | No studies |
Annual GFR loss (mL/min/1.73 m2) Leflunomide regimen vs no leflunomide regimen | no estimate extracted | NR | No studies |
Death (any cause) Leflunomide regimen vs no leflunomide regimen | no estimate extracted | NR | No studies |
Infection Leflunomide regimen vs no leflunomide regimen | RR 0.97 [0.45, 2.09] | 3 studies · 387 participants | Very low Downgraded: risk of bias |
Malignancy Leflunomide regimen vs no leflunomide regimen | no estimate extracted | NR | No studies |