{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T22:15:11Z","timestamp":1783721711646,"version":"3.55.0"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clinical trials in rare glomerular disease may establish short-term treatment efficacy but are limited by small sample sizes and short study duration. Observational data are needed to assess longer-term outcomes and can provide insights into real-world prescribing practices. This study applied modern statistical methods to real-world data from the Cure Glomerulonephropathy (CureGN) network to compare the effectiveness of rituximab and calcineurin inhibitors on long-term primary membranous nephropathy outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>CureGN participants with biopsy-confirmed primary membranous nephropathy who initiated either of the two treatments at least 6 months after any previous immunosuppressant exposure were eligible. Inverse-probability-of-treatment weighting balanced covariates at treatment initiation. Inverse-probability-of-censoring weights accounted for censoring individuals if another immunosuppressant was started during follow-up. Outcomes included time from treatment initiation to composite kidney disease progression (40% decline in eGFR, kidney replacement therapy, or eGFR &lt;15), proteinuria remission, and relapse following remission. Hazard ratios and differences in restricted mean survival times were estimated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      325 treatment initiations across 250 unique participants were eligible, with median follow-up 53 months (25\n                      <jats:sup>th<\/jats:sup>\n                      -75\n                      <jats:sup>th<\/jats:sup>\n                      percentile: 24-79). Participants on calcineurin inhibitors had significantly higher risks of disease progression (HR=2.81; 95% CI: 1.16, 6.80). Hazard ratios for proteinuria remission (HR=0.77; 95% CI: 0.50, 1.17) and relapse (HR=1.42, 95% CI: 0.69, 2.92) had wide confidence intervals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Rituximab was associated with better kidney function preservation than calcineurin inhibitors over long follow-up. Proteinuria remission and relapse results favored rituximab but did not reach statistical significance. Long-term treatment comparative effectiveness in rare diseases can be evaluated with real-world data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.34067\/kid.0000001265","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T22:00:33Z","timestamp":1783720833000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Real-World Long-term Comparisons of Rituximab versus Calcineurin Inhibitors for Membranous Nephropathy in the Cure Glomerulonephropathy Study"],"prefix":"10.34067","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8586-5139","authenticated-orcid":false,"given":"Meghan K.","family":"Gerety","sequence":"first","affiliation":[{"name":"Division of Biostatistics, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7147-9026","authenticated-orcid":false,"given":"Vivek","family":"Charu","sequence":"additional","affiliation":[{"name":"Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA"},{"name":"Department of Pathology, Stanford University School of Medicine, Stanford, CA. USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7742-8542","authenticated-orcid":false,"given":"Madison","family":"Simmons","sequence":"additional","affiliation":[{"name":"Howard University, Washington, D.C., USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8367-0522","authenticated-orcid":false,"given":"Nicholas J.","family":"Seewald","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2796-3037","authenticated-orcid":false,"given":"Dorey A.","family":"Glenn","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, UNC Kidney Center, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9792-4474","authenticated-orcid":false,"given":"Douglas E.","family":"Schaubel","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5496-4460","authenticated-orcid":false,"given":"Abigail R.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Informatics, Department of Preventive Medicine, Northwestern University, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6078-8392","authenticated-orcid":false,"given":"Dhruti","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, UNC Kidney Center, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1598-5562","authenticated-orcid":false,"given":"Louis-Philippe","family":"Laurin","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Maisonneuve-Rosemont Hospital, Montreal, Canada"},{"name":"Department of Medicine, University of Montreal, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Denburg","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA"},{"name":"Division of Nephrology, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"},{"name":"Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8961-234X","authenticated-orcid":false,"given":"Lawrence B.","family":"Holzman","sequence":"additional","affiliation":[{"name":"Renal-Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence H.","family":"Beck","sequence":"additional","affiliation":[{"name":"Nephrology Section, Department of Medicine, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6055-764X","authenticated-orcid":false,"given":"Laura H.","family":"Mariani","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0586-1160","authenticated-orcid":false,"given":"Jarcy","family":"Zee","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA"},{"name":"Children\u2019s Hospital of Philadelphia Research Institute, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,10]]},"container-title":["Kidney360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.34067\/KID.0000001265","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T22:00:33Z","timestamp":1783720833000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.34067\/KID.0000001265"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,10]]},"references-count":0,"URL":"https:\/\/doi.org\/10.34067\/kid.0000001265","relation":{},"ISSN":["2641-7650"],"issn-type":[{"value":"2641-7650","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,10]]},"assertion":[{"value":"2026-02-12","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-17","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}