Risk of serious infections with immunosuppressive drugs and glucocorticoids for lupus nephritis: a systematic review and network meta-analysis

Table 2 Serious infection risk in patients with lupus nephritis with various immunosuppressive drugs or corticosteroids showing only the statistically significant results

Treatment	Reference	OR (95 % CrI)	RR (95 % CrI)	RD (95 % Crl)
TAC	Glucocorticoids	0.33 (0.12–0.88)	0.36 (0.14–0.90)	–0.09 (–0.15 to –0.01)
TAC	CYC	0.37 (0.15–0.87)	0.41 (0.17–0.88)	–0.07 (–0.14 to –0.01)
TAC	MMF	0.40 (0.18–0.81)	0.43 (0.21–0.83)	–0.07 (–0.14 to –0.02)
TAC	AZA	0.32 (0.12–0.81)	0.35 (0.14–0.83)	–0.09 (–0.20 to –0.02)
CYC LD	TAC	4.84 (1.48–17.64)	4.00 (1.43–11.47)	0.15 (0.03 to 0.40)
HD glucocorticoids	TAC	12.83 (1.53–119.90)	7.67 (1.47–25.14)	0.35 (0.03 to 0.79)
CYC HD	TAC	6.60 (2.25–20.50)	5.06 (2.03–12.89)	0.20 (0.07 to 0.43)
MMF-AZA	CYC LD	0.09 (0.01–0.76)	0.11 (0.01–0.79)	–0.17 (–0.43 to –0.03)
MMF-AZA	HD glucocorticoids	0.03 (0.00–0.56)	0.06 (0.00–0.61)	–0.37 (–0.82 to –0.04)
MMF-AZA	CYC HD	0.07 (0.01–0.54)	0.09 (0.01–0.60)	–0.22 (–0.46 to –0.06)
MMF-AZA	CYC-AZA	0.14 (0.02–0.71)	0.16 (0.02–0.75)	–0.11 (–0.29 to –0.02)

All odds ratios are statistically significant
High-dose (HD) glucocorticoids were defined as one of the following or a similar regimen: (1) prednisone or methylprednisolone 1 gm/m² qd intravenous × 3 at entry, then one dose intravenous q month for 1 year; (2) prednisone 1 mg/kg po qd with a slow taper up to 1 year or longer taper (or unspecified taper in an occasional case)
Glucocorticoids were defined as one of the following or a similar regimen: (1) prednisone 40 mg po qod for 8 weeks then taper to 10 mg qd within a year; (2) 60 mg qd for 1–3 months reduced to 20 mg/d by 6 months
CYC, low dose (LD): CYC IV 500 mg q 14 d × 6 doses or a similar regimen
CYC: CYC IV 0.5–1.0 gm/m² q 2 month for 1 year or CYC PO 1–4 mg/kg daily for 4 years (standard dose) or a similar regimen
CYC, HD: CYC IV 0.5–1.0 gm/m² q month × 6–9 months, then q3 months for 0.5–4 years or CYC PO 10 mg/kg daily or a similar regimen
MMF-AZA: MMF followed by AZA
CYC-AZA: CYC followed by AZA
CYC cyclophosphamide, MMF mycophenolate mofetil, AZA azathioprine, TAC tacrolimus, HD high dose, LD low dose

ISSN: 1741-7015