SynthesisBMC medicine2016
Risk of serious infections with immunosuppressive drugs and glucocorticoids for lupus nephritis: a systematic review and network meta-analysis.
Synthesis in BMC medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05158751 (Myocarditis Causing Premature Ventricular Contractions), which is not on this map. Cited by 78 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Myocarditis Causing Premature Ventricular Contractions:Insights From the MAVERIC Registry
Who cites it
78 citing papers in PubMed, 4 syntheses or guidelines pooled it, 173 citations in OpenAlex.
- Saudi National Clinical Practice Guidelines for Management of Adult Systemic Lupus Erythematosus.Current rheumatology reviews · 2025Guideline
- The risk of infections in adult patients with systemic lupus erythematosus: systematic review and meta-analysis.Rheumatology (Oxford, England) · 2021Pooled it
- Pooled it
- Comparative Efficacy of Chinese Herbal Injections for Pulmonary Heart Disease: A Bayesian Network Meta-Analysis of Randomized Controlled Trials.Frontiers in pharmacology · 2020Pooled it
- Mycophenolate mofetil withdrawal in patients with systemic lupus erythematosus: a multicentre, open-label, randomised controlled trial.The Lancet. Rheumatology · 2024Trial
- Individualized decision aid for diverse women with lupus nephritis (IDEA-WON): A randomized controlled trial.PLoS medicine · 2019Trial
- Individualized patient decision-aid for immunosuppressive drugs in women with lupus nephritis: study protocol of a randomized, controlled trial.BMC musculoskeletal disorders · 2017Trial
- Impact of race on comorbidity burden and clinical outcomes among Southeast Asians with lupus nephritis: a single-center retrospective study.International urology and nephrology · 2026Article
- A real-world, triple-cohort study on the effectiveness and safety of telitacicept in immunosuppressant-naïve and refractory lupus nephritis.Frontiers in immunology · 2026Article
- Where, How, and How Much? A Multicenter Cohort Study of the Relationship Across Lupus Decision-Aid Modality, Place of Administration, Interruption and Viewing Completeness, and Patient-Reported Outcomes.Arthritis care & research · 2025Observational
- Comparison of the immunogenicity and safety among COVID-19 vaccines ChadOx-1, CoronaVac and BNT162b2 in systemic lupus erythematosus (SLE) patients: a prospective cohort.Advances in rheumatology (London, England) · 2025Article
- Article
- 2025 Chinese guidelines for the diagnosis and treatment of systemic lupus erythematosus.Rheumatology and immunology research · 2025Article
- Serum bactericidal activity against meningococcus in patients with systemic lupus erythematosus.Clinical and experimental pediatrics · 2025Article
- Time required to implement a computerized patient decision aid for lupus in outpatient visits.Implementation science communications · 2025Article
- Cyclophosphamide treatment with a comparison in both pediatric rheumatology and pediatric nephrology practices.Pediatric rheumatology online journal · 2025Article
- Risk of hematologic malignancies in psoriasis and rheumatoid arthritis patients using long term TNF-α inhibitors: a retrospective nationwide study.Scientific reports · 2025Article
- Real-world oral glucocorticoid use in SLE: a nation-wide population-based study using the French medico-administrative (SNDS) claim database.Lupus science & medicine · 2025Article
- Neuro-ophthalmologic Outcomes of Orbital Apex Syndrome Caused by Invasive Fungal Rhinosinusitis.Journal of neurological surgery. Part B, Skull base · 2025Article
- The interface of depression and diabetes: treatment considerations.Translational psychiatry · 2025Review
18 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo perform a systematic review and network meta-analysis (NMA) to compare the risk of serious infections with immunosuppressive medications and glucocorticoids in lupus nephritis.
methodsA trained librarian performed two searches: (1) PubMed for all lupus nephritis trials from the end dates for the systematic review for the 2012 American College of Rheumatology (ACR) lupus nephritis treatment guidelines and the 2012 Cochrane Systematic Review on treatments for lupus nephritis, to September 2013; and (2) PubMed and SCOPUS for all lupus trials (excluding lupus nephritis) from inception to February 2014, to obtain additional trials for harms data in any lupus patient. The search was updated to May 2016. Duplicate title/abstract review and duplicate data abstractions by two abstractors independently was performed for all eligible studies, including those studies abstracted for the 2012 ACR lupus nephritis treatment guidelines and the 2012 Cochrane Systematic Review on lupus nephritis treatments. We performed a systematic review and a Bayesian NMA, including randomized controlled trials (RCTs) of immunosuppressive drugs or glucocorticoids in patients with lupus nephritis assessing serious infection risk. Markov chain Monte Carlo methods were used to model 95 % credible intervals (CrI). Sensitivity analyses examined the robustness of estimates.
resultsA total of 32 RCTs with 2611 patients provided data. There were 26 two-arm, five three-arm, and one four-arm trials. We found that tacrolimus was associated with significantly lower risk of serious infections compared to glucocorticoids, cyclophosphamide (CYC), mycophenolate mofetil (MMF), and azathioprine (AZA) with odds ratios (95 % CrI) of 0.33 (0.12-0.88), 0.37 (0.15-0.87), 0.340 (0.18-0.81), and 0.32 (0.12-0.81), respectively. Conversely, CYC low dose (LD), CYC high dose (HD), and HD glucocorticoids were associated with higher odds of serious infections compared to tacrolimus, ranging from 4.84 to 12.83. We also found that MMF followed by AZA (MMF-AZA) was associated with significantly lower risk of serious infections as compared to CYC LD, CYC HD, CYC-AZA, or HD glucocorticoids with odds ratios (95 % CrI) of 0.09 (0.01-0.76), 0.07 (0.01-0.54), 0.14 (0.02-0.71), and 0.03 (0.00-0.56), respectively. Estimates were similar to pair-wise meta-analyses. Sensitivity analyses that varied estimate (odds ratio vs. Peto's odds ratio), method (random vs. fixed effects model), data (sepsis vs. serious infection data; exclusion of observational studies), treatment grouping (CYC and CYC HD as a combined treatment group vs. separate), made little/no difference to these estimates.
conclusionsTacrolimus and MMF-AZA combination were associated with lower risk of serious infections compared to other immunosuppressive drugs or glucocorticoids for lupus nephritis. In conjunction with comparative efficacy data, these data can help patients make informed decisions about treatment options for lupus nephritis. PROSPERO REGISTRATION: CRD42016032965.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.