Tacrolimus and mycophenolate mofetil as second-line treatment in autoimmune hepatitis: Is the evidence of sufficient quality to develop recommendations?

Figure 1 PRISMA flow diagram of the articles retrieved by systematic literature search. AIH: Autoimmune hepatitis.

Figure 2 Assessment of methodological quality (risk of bias) of articles identified in the systematic literature search and included in our meta-analysis.

Figure 3 The pooled event rate of biochemical remission in the tacrolimus group with risk of bias assessment per study. Heterogeneity: Q = 16.25, degree of freedom = 8 (P = 0.039); I² = 50.76%. Test for overall effect: Z = 4.21 (P < 0.0001). A: Failure to develop and apply appropriate eligibility criteria (inclusion of control population); B: Flawed measurement of both exposure and outcome; C: Failure to adequately control confounding; D: Incomplete follow-up. CI: Confidence interval.

Figure 4 The pooled event rate of biochemical remission in the mycophenolate mofetil group with risk of bias assessment per study. Heterogeneity: Q = 29.72, degree of freedom = 15 (P = 0.013); I² = 49.52%. Test for overall effect: Z = 3.85 (P = 0 < 0.0001). A: Failure to develop and apply appropriate eligibility criteria (inclusion of control population); B: Flawed measurement of both exposure and outcome; C: Failure to adequately control confounding; D: Incomplete follow-up. CI: Confidence interval.

Figure 5 The publication bias of included studies for biochemical remission in (A) tacrolimus and (B) mycophenolate mofetil groups.