Efficacy and safety of immunosuppressive medications for steroid-resistant nephrotic syndrome in children: a systematic review and network meta-analysis

Oncotarget
Shaojun LiLiping Tan

Abstract

Conventional meta-analyses and randomized controlled trials have shown inconsistent results regarding the efficacy of immunosuppressants for pediatric steroid-resistant nephrotic syndrome (SRNS). To conduct a network meta-analysis aimed at evaluating the efficacy and safety of available immunosuppressive agents in pediatric patients with SRNS. MEDLINE, the Cochrane Central Register of Controlled Trials, and EMBASE were searched on January 2017. Data from randomized controlled trials (RCTs) were included. The main outcomes analyzed were efficacy [number/portion with complete remission (CR), number/portion with partial remission (PR), and total number/portion in remission (TR)] and safety [adverse secondary event (ASE) rates]. A meta-analysis of 18 RCTs showed that tacrolimus was more efficacious for achieving CR than intravenous (i.v.) cyclophosphamide, mycophenolate mofetil (MMF), oral cyclophosphamide, leflunomide, chlorambucil, azathioprine, and plaebo/nontreatment (P/NT), and more efficacious than i.v. cyclophosphamide, oral cyclophosphamide, and P/NT in terms of TR outcomes. Cyclosporin was associated with a greater CR rate than i.v. cyclophosphamide, MMF, oral cyclophosphamide, chlorambucil, azathioprine, or P/NT, and asso...Continue Reading

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Citations

Nov 15, 2019·British Journal of Clinical Pharmacology·Guo-Xiang HaoWei Zhao
Sep 13, 2019·Pediatrics International : Official Journal of the Japan Pediatric Society·Shintaro TerashitaMasaaki Mori
Feb 23, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Jiwon M LeeJun Oh

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Methods Mentioned

BETA
pharmacotherapy
pharmacotherapies

Software Mentioned

Stata network suite
Stata

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