Title: TITLE: Intravenous tacrolimus is a superior induction therapy for acute severe ulcerative
colitis compared to oral tacrolimus
Version: 1 Date: 30 Sep 2021
Reviewer's report:
I've read the manuscript entitled "Intravenous tacrolimus is a superior induction therapy for
acute severe ulcerative colitis compared to oral tacrolimus" with great interests. Clinically, it
is very important to evaluate the efficacy of intravenous TAC for ASUC compared with oral
TAC. Because, as the authors mentioned, intravenous TAC could reach high trough level of
TAC faster resulting in improving clinical course of ASUC. However, I consider that there are
several problems in this paper for publication for BMC Gastroenterology.
Q1. Please describe the reason about the difference of the targeted trough level of TAC between
intravenous and oral TAC treatment.
Q2. Please describe the transition of TAC trough level for not only one week but also two weeks
in both intravenous and oral TAC treatment groups, because the authors evaluated the clinical
response and remission rate at week 1 and 2.
Q3. According to the data, I considered that the difference of clinical remission and response
rate between oral and intravenous TAC treatment groups would be due to the difference of the
targeted trough level of TAC. Therefore, if the target trough level of TAC in oral TAC treatment
group could be much high as like intravenous TAC group, clinical response and remission rate
would be improved. What do the authors think about that?
Q4. I considered that, as mentioned above, TAC trough level but not TAC administration method
might play an important role in clinical course. How about the clinical response and remission
rate stratifying the trough level of TAC at week 1 and 2?
Q5. I considered that, according to colectomy free survival data, the significant difference of
colectomy free survival at within week 5 would contribute to the difference of colectomy free
survival date at week 24 between intravenous and oral TAC treatment groups. Therefore, for
urgent cases like ASUC, how to reach at very high trough level of TAC (over 15 ng/ml) rapidly
would be very important. How do you think about it?
Title: TITLE: Intravenous tacrolimus is a superior induction therapy for acute severe ulcerative
colitis compared to oral tacrolimus
Version: 1 Date: 30 Sep 2021
Reviewer's report:
I've read the manuscript entitled "Intravenous tacrolimus is a superior induction therapy for
acute severe ulcerative colitis compared to oral tacrolimus" with great interests. Clinically, it
is very important to evaluate the efficacy of intravenous TAC for ASUC compared with oral
TAC. Because, as the authors mentioned, intravenous TAC could reach high trough level of
TAC faster resulting in improving clinical course of ASUC. However, I consider that there are
several problems in this paper for publication for BMC Gastroenterology.
Q1. Please describe the reason about the difference of the targeted trough level of TAC between
intravenous and oral TAC treatment.
Q2. Please describe the transition of TAC trough level for not only one week but also two weeks
in both intravenous and oral TAC treatment groups, because the authors evaluated the clinical
response and remission rate at week 1 and 2.
Q3. According to the data, I considered that the difference of clinical remission and response
rate between oral and intravenous TAC treatment groups would be due to the difference of the
targeted trough level of TAC. Therefore, if the target trough level of TAC in oral TAC treatment
group could be much high as like intravenous TAC group, clinical response and remission rate
would be improved. What do the authors think about that?
Q4. I considered that, as mentioned above, TAC trough level but not TAC administration method
might play an important role in clinical course. How about the clinical response and remission
rate stratifying the trough level of TAC at week 1 and 2?
Q5. I considered that, according to colectomy free survival data, the significant difference of
colectomy free survival at within week 5 would contribute to the difference of colectomy free
survival date at week 24 between intravenous and oral TAC treatment groups. Therefore, for
urgent cases like ASUC, how to reach at very high trough level of TAC (over 15 ng/ml) rapidly
would be very important. How do you think about it?
Please review this paper.
user
Title: TITLE: Intravenous tacrolimus is a superior induction therapy for acute severe ulcerative
colitis compared to oral tacrolimus
Version: 1 Date: 30 Sep 2021
Reviewer's report:
I've read the manuscript entitled "Intravenous tacrolimus is a superior induction therapy for
acute severe ulcerative colitis compared to oral tacrolimus" with great interests. Clinically, it
is very important to evaluate the efficacy of intravenous TAC for ASUC compared with oral
TAC. Because, as the authors mentioned, intravenous TAC could reach high trough level of
TAC faster resulting in improving clinical course of ASUC. However, I consider that there are
several problems in this paper for publication for BMC Gastroenterology.
Q1. Please describe the reason about the difference of the targeted trough level of TAC between
intravenous and oral TAC treatment.
Q2. Please describe the transition of TAC trough level for not only one week but also two weeks
in both intravenous and oral TAC treatment groups, because the authors evaluated the clinical
response and remission rate at week 1 and 2.
Q3. According to the data, I considered that the difference of clinical remission and response
rate between oral and intravenous TAC treatment groups would be due to the difference of the
targeted trough level of TAC. Therefore, if the target trough level of TAC in oral TAC treatment
group could be much high as like intravenous TAC group, clinical response and remission rate
would be improved. What do the authors think about that?
Q4. I considered that, as mentioned above, TAC trough level but not TAC administration method
might play an important role in clinical course. How about the clinical response and remission
rate stratifying the trough level of TAC at week 1 and 2?
Q5. I considered that, according to colectomy free survival data, the significant difference of
colectomy free survival at within week 5 would contribute to the difference of colectomy free
survival date at week 24 between intravenous and oral TAC treatment groups. Therefore, for
urgent cases like ASUC, how to reach at very high trough level of TAC (over 15 ng/ml) rapidly
would be very important. How do you think about it?
assistant