Table 1

Meta-analyses of remission induction treatment with pulsed versus continuous oral CYC in GPA and MPA

Study IDInterventionControlOutcomeIncluded studiesNo. of participantsSummary estimateEffects sizeHeterogeneity
Death
 Nagasaka et al71Pulse CYCContinuous CYCDeath at 1 year3 RCT246RR (95% CI)0.47 (0.23 to 0.99)I2=0%
 Springer et al16Pulse CYCContinuous CYCMortality4 RCT296OR (95% CI)0.56 (0.29 to 1.07)I2=0%
 Walters et al15Pulse CYCContinuous CYCDeath at final FU4 RCT278RR (95% CI)0.77 (0.44 to 1.32)I2=15%
Remission
 Nagasaka et al71Pulse CYCContinuous CYCRemission3 RCT246RR (95% CI)1.07 (0.96 to 1.19)I2=15%
 Walters et al15Pulse CYCContinuous CYCRemission at 6 months2 RCT176RR (95% CI)1.03 (0.93 to 1.13)I2=0%
Relapse
 Springer et al16Pulse CYCContinuous CYCRelapse4 RCT284OR (95% CI)2.04 (1.11 to 3.75)I2=0%
 Walters et al15Pulse CYCContinuous CYCRelapse at end of FU4 RCT235RR (95% CI)1.79 (1.11 to 2.87)I2=0%
Leucopenia
 Springer et al16Pulse CYCContinuous CYCLeucopenia3 RCT250OR (95% CI)0.37 (0.20 to 0.69)I2=16%
 Walters et al15Pulse CYCContinuous CYCLeucopenia4 RCT278RR (95% CI)0.53 (0.36 to 0.77)I2=0%
Serious infection
 Nagasaka et al71Pulse CYCContinuous CYCSerious infection3 RCT246RR (95% CI)0.56 (0.37 to 0.86)I2=0%
 Walters et al15Pulse CYCContinuous CYCSerious infection4 RCT278RR (95% CI)0.71 (0.38 to 1.33)I2=71%
  • I2 refers to the proportion of overall variability that rises from between-study heterogeneity.

  • CYC, cyclophosphamide; FU, follow-up; GPA, granulomatosis with polyangiitis; MPA, microscopic polyangiitis; RCT, randomised controlled trial; RR, risk ratio.