Title: Risk of Clostridioides difficile infection in inflammatory bowel disease patients
undergoing vedolizumab treatment: a systematic review and meta-analysis
Version: 1 Date: 14 Jul 2024
Reviewer's report:
The author has responded to the queries with a bibliographic discussion and additional subgroup
analyses. However, the response is rather confusing.
Regarding the inclusion criteria, the content addressed in the response has not been reflected in
the main text, and limitations should also be added to the manuscript. It is difficult for readers
to understand and may lead to misinterpretation of the results.
As the authors have mentioned, in the context of IBD, it is known that the results of clinical
trials can differ from those observed in the real world. Therefore, if the aim is to evaluate the risk
of CDI in the real world, clinical trials should be excluded at the inclusion criteria stage, even
if the results suggest that the impact of clinical trials on the meta-analysis results is minimal.
The consideration that the impact is negligible due to the small number of RCTs collected in
the study is biased and unacceptable. Furthermore, if RCTs are not to be excluded, at the very
least, they should be discussed as a limitation.
The primary outcome is the incidence of CDI in IBD patients, but the results are unclear. It
would be better to understand if the incidence of CDI were reported separately for UC and CD.
Title: Risk of Clostridioides difficile infection in inflammatory bowel disease patients
undergoing vedolizumab treatment: a systematic review and meta-analysis
Version: 1 Date: 14 Jul 2024
Reviewer's report:
The author has responded to the queries with a bibliographic discussion and additional subgroup
analyses. However, the response is rather confusing.
Regarding the inclusion criteria, the content addressed in the response has not been reflected in
the main text, and limitations should also be added to the manuscript. It is difficult for readers
to understand and may lead to misinterpretation of the results.
As the authors have mentioned, in the context of IBD, it is known that the results of clinical
trials can differ from those observed in the real world. Therefore, if the aim is to evaluate the risk
of CDI in the real world, clinical trials should be excluded at the inclusion criteria stage, even
if the results suggest that the impact of clinical trials on the meta-analysis results is minimal.
The consideration that the impact is negligible due to the small number of RCTs collected in
the study is biased and unacceptable. Furthermore, if RCTs are not to be excluded, at the very
least, they should be discussed as a limitation.
The primary outcome is the incidence of CDI in IBD patients, but the results are unclear. It
would be better to understand if the incidence of CDI were reported separately for UC and CD.
Please review this paper.
user
Title: Risk of Clostridioides difficile infection in inflammatory bowel disease patients
undergoing vedolizumab treatment: a systematic review and meta-analysis
Version: 1 Date: 14 Jul 2024
Reviewer's report:
The author has responded to the queries with a bibliographic discussion and additional subgroup
analyses. However, the response is rather confusing.
Regarding the inclusion criteria, the content addressed in the response has not been reflected in
the main text, and limitations should also be added to the manuscript. It is difficult for readers
to understand and may lead to misinterpretation of the results.
As the authors have mentioned, in the context of IBD, it is known that the results of clinical
trials can differ from those observed in the real world. Therefore, if the aim is to evaluate the risk
of CDI in the real world, clinical trials should be excluded at the inclusion criteria stage, even
if the results suggest that the impact of clinical trials on the meta-analysis results is minimal.
The consideration that the impact is negligible due to the small number of RCTs collected in
the study is biased and unacceptable. Furthermore, if RCTs are not to be excluded, at the very
least, they should be discussed as a limitation.
The primary outcome is the incidence of CDI in IBD patients, but the results are unclear. It
would be better to understand if the incidence of CDI were reported separately for UC and CD.
assistant