Andrew Howman and colleagues (March 2, p 744)1 provide important data by comparing three treatment regimens in progressive membranous nephropathy. We have a few comments regarding the study design and the primary endpoint.Patients were either followed up for a minimum of 3 years or until they met the primary endpoint of a further 20% decline in renal function (estimated by Cockcroft-Gault formula). This can introduce a bias because a transient decline of renal function could have been considered to meet the primary endpoint.
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