Title: Identification of Inadequate Responders to Advanced Therapy Among Commercially-
Insured Adult Patients with Crohn’s Disease and Ulcerative Colitis in the United States
Version: 1 Date: 19 Sep 2022
Reviewer's report:
Dr. Hunter et al investigated the frequency of inadequate response over 1 year from advanced
therapy initiation among patients with Crohn’s disease (CD) or ulcerative colitis (UC) in the
United States using a claims-based algorithm. The authors showed that more than 60% of
patients with CD or UC had an inadequate response to their index advanced therapy within 1
year after initiation, mostly driven by low adherence. This highly novel study used a claim-based
algorithm to assess the frequency of inadequate response to advanced therapy.
However, I think this study's methodology and discussion contents still have some problems as
indicated below.
Major comments:
1. In this study, the definition of inadequate response was listed in Table 1.
The reviewer feels uncomfortable with this definition.
Low adherence to advanced therapy may cause inadequate response to advanced therapy,
however, I don’t think that low adherence to advanced therapy is not always a predictor of
inadequate response.
Low adherence (defined as proportion of days covered [PDC] < 80%) may also be due to
adequate response to advanced therapy.
I recommend you reconsider whether low adherence is always a predictor of inadequate response
and include it in the text.
2. In this study factors associated with inadequate response were investigated
and the result was described in the part of the Factors influencing inadequate response to
advanced therapy in the Results section. However, they were not mentioned in the discussion
part. I encourage you to consider these matters in the discussion part.
I hope these comments will be helpful.
Title: Identification of Inadequate Responders to Advanced Therapy Among Commercially-
Insured Adult Patients with Crohn’s Disease and Ulcerative Colitis in the United States
Version: 1 Date: 19 Sep 2022
Reviewer's report:
Dr. Hunter et al investigated the frequency of inadequate response over 1 year from advanced
therapy initiation among patients with Crohn’s disease (CD) or ulcerative colitis (UC) in the
United States using a claims-based algorithm. The authors showed that more than 60% of
patients with CD or UC had an inadequate response to their index advanced therapy within 1
year after initiation, mostly driven by low adherence. This highly novel study used a claim-based
algorithm to assess the frequency of inadequate response to advanced therapy.
However, I think this study's methodology and discussion contents still have some problems as
indicated below.
Major comments:
1. In this study, the definition of inadequate response was listed in Table 1.
The reviewer feels uncomfortable with this definition.
Low adherence to advanced therapy may cause inadequate response to advanced therapy,
however, I don’t think that low adherence to advanced therapy is not always a predictor of
inadequate response.
Low adherence (defined as proportion of days covered [PDC] < 80%) may also be due to
adequate response to advanced therapy.
I recommend you reconsider whether low adherence is always a predictor of inadequate response
and include it in the text.
2. In this study factors associated with inadequate response were investigated
and the result was described in the part of the Factors influencing inadequate response to
advanced therapy in the Results section. However, they were not mentioned in the discussion
part. I encourage you to consider these matters in the discussion part.
I hope these comments will be helpful.
Please review this paper.
user
Title: Identification of Inadequate Responders to Advanced Therapy Among Commercially-
Insured Adult Patients with Crohn’s Disease and Ulcerative Colitis in the United States
Version: 1 Date: 19 Sep 2022
Reviewer's report:
Dr. Hunter et al investigated the frequency of inadequate response over 1 year from advanced
therapy initiation among patients with Crohn’s disease (CD) or ulcerative colitis (UC) in the
United States using a claims-based algorithm. The authors showed that more than 60% of
patients with CD or UC had an inadequate response to their index advanced therapy within 1
year after initiation, mostly driven by low adherence. This highly novel study used a claim-based
algorithm to assess the frequency of inadequate response to advanced therapy.
However, I think this study's methodology and discussion contents still have some problems as
indicated below.
Major comments:
1. In this study, the definition of inadequate response was listed in Table 1.
The reviewer feels uncomfortable with this definition.
Low adherence to advanced therapy may cause inadequate response to advanced therapy,
however, I don’t think that low adherence to advanced therapy is not always a predictor of
inadequate response.
Low adherence (defined as proportion of days covered [PDC] < 80%) may also be due to
adequate response to advanced therapy.
I recommend you reconsider whether low adherence is always a predictor of inadequate response
and include it in the text.
2. In this study factors associated with inadequate response were investigated
and the result was described in the part of the Factors influencing inadequate response to
advanced therapy in the Results section. However, they were not mentioned in the discussion
part. I encourage you to consider these matters in the discussion part.
I hope these comments will be helpful.
assistant