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Induction and Maintenance Immunosuppression Treatment of Proliferative Lupus Nephritis: A Network Meta-analysis of Randomized Trials  Suetonia C. Palmer,

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Presentation on theme: "Induction and Maintenance Immunosuppression Treatment of Proliferative Lupus Nephritis: A Network Meta-analysis of Randomized Trials  Suetonia C. Palmer,"— Presentation transcript:

1 Induction and Maintenance Immunosuppression Treatment of Proliferative Lupus Nephritis: A Network Meta-analysis of Randomized Trials  Suetonia C. Palmer, MBChB, PhD, David J. Tunnicliffe, MIPH, Davinder Singh-Grewal, MBBS, PhD, Dimitris Mavridis, PhD, Marcello Tonelli, MD, David W. Johnson, MBBS (Hons), PhD, Jonathan C. Craig, MBChB, PhD, Allison Tong, PhD, Giovanni F.M. Strippoli, MD, PhD  American Journal of Kidney Diseases  Volume 70, Issue 3, Pages (September 2017) DOI: /j.ajkd Copyright © 2017 The Authors Terms and Conditions

2 Figure 1 Summary of evidence search and selection.
American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2017 The Authors Terms and Conditions

3 Figure 2 Graphic representation of treatment comparisons for efficacy and safety of induction immunosuppression treatment for proliferative lupus nephritis. Lines represent trials comparing 2 classes of drug or drugs for (A) complete remission of lupus nephritis, (B) all-cause mortality, and (C) end-stage kidney disease. Numbers on connecting lines represent the number of studies/number of participants in trials directly comparing the two treatments. The nodes indicate the drug treatments assessed in existing trials. The size of the node is proportional to the number of studies evaluating the treatment. For example, the most commonly evaluated treatment for complete remission of lupus nephritis is intravenous cyclophosphamide. Abbreviation: MMF, mycophenolate mofetil. American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2017 The Authors Terms and Conditions

4 Figure 3 Rankings for efficacy and safety of immunosuppression treatment to induce disease remission in lupus nephritis. The graphs display the distribution of probabilities of treatment ranking from best through worst for each outcome. Ranking indicates the probability that drug class is first “best,” second “best,” etc. For example, the ranking suggests that oral cyclophosphamide treatment posed the highest risk for incurring ovarian failure (worst), while prednisone incurred the lowest probability of ovarian failure (best). Mycophenolate mofetil (MMF) and calcineurin inhibitors were among the best treatments for inducing disease remission, while intravenous cyclophosphamide and prednisone alone provided the lowest probability of disease remission (worst). American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2017 The Authors Terms and Conditions

5 Figure 4 Rankings for efficacy of immunosuppression as maintenance therapy to prevent disease relapse in lupus nephritis. Graph displays distribution of probabilities for each outcome. Ranking indicates probability that drug class is first “best,” second best, etc. For example, mycophenolate mofetil (MMF) is among the best for preventing disease relapse during maintenance therapy, while intravenous cyclophosphamide is among the worst. American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2017 The Authors Terms and Conditions


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