Meta-analyses of remission induction treatment with mycophenolate versus cyclophosphamide in GPA and MPA
| Study ID | Intervention | Control | Outcome | Included studies | No. of participants | Summary estimate | Effects size | Heterogeneity |
| Remission | ||||||||
| Berti et al29 | MMF | CYC | Remission induction | 4 RCT | 300 | OR (95% CI) | 1.06 (0.74 to 1.52) | I2=0% |
| Kuzuya et al55 | MMF | CYC | Remission at 6 months | 4 RCT | 300 | RR (95% CI) | 1.09 (0.86 to 1.38) | I2=60% |
| Song and Lee86 | MMF | CYC | Remission | 4 RCT | 300 | RR (95% CI) | 1.311 (0.570 to 3.017) | I2=57.4% |
| Xiong et al99 | MMF | CYC | Remission | 4 RCT | 290 | OR (95% CI) | 1.30 (0.56 to 3.04) | I2=57% |
| Relapse | ||||||||
| Kuzuya et al55 | MMF | CYC | Relapse | 2 RCT | 189 | RR (95% CI) | 1.36 (0.80 to 2.31) | I2=45% |
| Song and Lee86 | MMF | CYC | Relapse | 2 RCT | 224 | RR (95% CI) | 1.331 (0.497 to 3.568) | I2=63.4% |
| Leucopenia | ||||||||
| Kuzuya et al55 | MMF | CYC | Leucopenia | 3 RCT | 160 | RR (95% CI) | 0.45 (0.16 to 1.32) | I2=0% |
| Xiong et al99 | MMF | CYC | Leucopenia | 3 RCT | 150 | OR (95% CI) | 0.38 (0.12 to 1.21) | I2=0% |
| Infection | ||||||||
| Kuzuya et al55 | MMF | CYC | Infection | 4 RCT | 300 | RR (95% CI) | 1.26 (0.79 to 2.01) | I2=0% |
| Song and Lee86 | MMF | CYC | Infection | 4 RCT | 300 | RR (95% CI) | 0.958 (0.561 to 1.634) | I2=28.5% |
| Xiong et al99 | MMF | CYC | Infection | 4 RCT | 290 | OR (95% CI) | 0.82 (0.35 to 1.91) | I2=49% |
| Other outcomes | ||||||||
| Kuzuya et al55 | MMF | CYC | Death | 4 RCT | 300 | RR (95% CI) | 1.05 (0.40 to 2.74) | I2=0% |
| Kuzuya et al55 | MMF | CYC | Severe infection or death | 4 RCT | 300 | RR (95% CI) | 0.87 (0.31 to 2.50) | I2=0% |
| Kuzuya et al55 | MMF | CYC | ESKD | 2 RCT | 181 | RR (95% CI) | 0.66 (0.15 to 2.79) | I2=0% |
| Kuzuya et al55 | MMF | CYC | Malignancy | 2 RCT | 224 | RR (95% CI) | 1.04 (0.27 to 3.98) | I2=0% |
| Song and Lee86 | MMF | CYC | SAE | 4 RCT | 300 | RR (95% CI) | 1.232 (0.754 to 2.014) | I2=0% |
I2 refers to the proportion of overall variability that rises from between-study heterogeneity. Bayesian network meta-analysis of RCTs comparing CYC, RTX and MMF induction reported in online supplemental file 2.57
CYC, cyclophosphamide; ESKD, end-stage kidney disease; GPA, granulomatosis with polyangiitis; MMF, mycophenolate mofetil; MPA, microscopic polyangiitis; RCT, randomised controlled trial; RR, risk ratio; SAE, serious adverse event.