Randomised controlled trials (RCTs) were identified from the Cochrane Renal Group's specialised register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and reference lists of articles.
SELECTION CRITERIA: Two authors independently searched the literature, determined study eligibility, assessed quality and extracted data. For dichotomous outcomes, results were expressed as risk ratios (RR) and 95% confidence intervals (CI). Data were pooled using the random effects model.
MAIN RESULTS: Fourteen RCTs (449 children) were included.
Cyclosporin when compared with placebo or no treatment significantly increased the number of children who achieved complete remission (three studies, 49 children: RR 7.66, 95% CI 1.06 to 55.34).
Cyclosporin significantly increased the number with complete or partial remission compared with IV
cyclophosphamide (one study, 32 children: RR 3.40, 95% CI 1.12 to 10.28). There was no significant difference in the number who achieved complete remission between oral
cyclophosphamide with
prednisone versus
prednisone alone (two studies, 91 children: RR 1.06, 95% CI 0.61 to 1.87), IV versus oral
cyclophosphamide (one study, 11 children: RR 3.13, 95% CI 0.81 to 12.06), IV
cyclophosphamide versus oral
cyclophosphamide with IV
dexamethasone (one study, 49 children: RR 1.13, 95% CI 0.65 to 1.96),
tacrolimus versus
cyclosporin (one study, 41 children: RR 0.86, 95% CI 0.44 to 1.66) and
azathioprine with
prednisone versus
prednisone alone (one study, 31 children: RR 0.94, 95% CI 0.15 to 5.84). ACEi significantly reduced
proteinuria (two studies, 70 children). No studies were identified comparing high dose
steroids and
cyclosporin with single agents, placebo or no treatment.
AUTHORS' CONCLUSIONS: