Volume 59, Issue 5, Pages (May 2001)

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Volume 59, Issue 5, Pages 1919-1927 (May 2001) Immunosuppressive agents in childhood nephrotic syndrome: A meta-analysis of randomized controlled trials  Anne M. Durkan, Elisabeth M. Hodson, Narelle S. Willis, Jonathan C. Craig  Kidney International  Volume 59, Issue 5, Pages 1919-1927 (May 2001) DOI: 10.1046/j.1523-1755.2001.0590051919.x Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 1 Meta-analyses of the relative risks (RR) and 95% confidence intervals (95% CIs) for relapse of NS by 4 to 12 months in 10 trials of immunosuppressive agents compared with prednisone, placebo, or no treatment in children with relapsing NS. Results shown ordered by trial weights. (A) Cyclophosphamide compared with prednisone. (B) Levamisole compared with prednisone or no treatment. (C) Chlorambucil compared with prednisone. (D) Azathioprine compared with prednisone. No heterogeneity was demonstrated using Cochran's Q statistic (chi-square). The test statistic Z indicates that cyclophosphamide, chlorambucil, and levamisole are significantly more effective in reducing the number of children who relapse compared with prednisone or no treatment, while azathioprine is no more effective than prednisone alone. The numbers in the experimental treatment column and control treatment column indicate the number of children (n) who suffered a relapse of nephrotic syndrome (NS) compared with the total number of children (N) who were treated. The relative risks (RR) with 95% CIs are shown graphically and numerically for individual studies and as a summary estimate (total) for the combined studies. The data were analyzed using the random effects model, which takes into account the between-study variability as well as the within-study variability. Individual effect sizes (weight percentage) are weighted according to the inverse of their variance. Cochran's Q statistic, shown as chi-square analysis with degrees of freedom (d.f.), provides the formal test of heterogeneity between studies. The test statistic Z is the formal test of significant effect. Studies are listed by first author and year of publication. The abbreviations ISKDC (in meta-analyses of cyclophosphamide and azathioprine) and BAPN (in meta-analysis of levamisole) refer to the International Study of Kidney Disease in Children and British Association for Paediatric Nephrology, respectively. Kidney International 2001 59, 1919-1927DOI: (10.1046/j.1523-1755.2001.0590051919.x) Copyright © 2001 International Society of Nephrology Terms and Conditions