Eight RCTs (1,871 patients) were included; 1,858 patients were used in the analysis.
Seven of the 8 RCTs were double-blind. Four RCTs described the method of randomisation. All studies reported the use of intention-to-treat analysis, but in 3 studies patients were excluded after randomisation.
The addition of interleukin-2 receptor antibodies significantly reduced the risk of acute rejection at 6 months (OR 0.51, 95% CI: 0.42, 0.63, P<0.0001). No statistically significant heterogeneity was detected (P=0.7).
There was no statistically significant difference between treatments for graft loss at 1 year (OR 0.78, 95% CI: 0.58, 1.04), mortality at 1 year (OR 0.75, 95% CI: 0.46, 1.23), overall incidence of injections at 3 months to 1 year (OR 0.97, 95% CI: 0.77, 1.24), cytomegalovirus infection at 3 months to 1 year (OR 0.81, 95% CI: 0.62, 1.04), or risk of lymphoma or other malignancies at 1 year (OR 0.82, 95% CI: 0.39, 1.70). No statistically significant heterogeneity was detected for any of these analyses (P=0.1 to P=1.0).
There was no statistically significant difference between different antibiotics in acute rejection (P=0.7).
There was no statistically significant difference between the three immunosuppressive regimens (P=1.0).