Reviewer ’s report  
 
Title: Hypophosphataemia after ferric carboxymaltose is un related to symptoms, intestinal 
inflammation or vitamin D status  
 
Version: 1 Date: 13 Mar 2020  
 
Reviewer: Trond Espen Detlie  
 
Reviewer's report:  
 
Congratulations on a nice paper.  
 
I still feel that my comment related to line 239 -246 in the previous version, now line 197 -204 in 
the current ver sion, is relevant. However, if the authors choose to keep this section I would 
recommend to specify how many of the 5 patients had received FCM within the last 6 months 
and make a comment on if any of the patients had a state of hypophosphatemia at inclusi on of 
this study. The theory of an additive effect of repetitive infusions of FCM is that the patients 
have not had the time to normalize their blood values before the next infusion. This includes 
phosphate, iFGF23, PTH, ionized calcium, Vitamin d etc. Sin ce there is no good data (except for 
some case reports) on a prolonged effect beyond 6 months I feel this needs to be addressed when 
using a timeline of 12 months in this section. The way it is now phrased might give a misleading 
impression that there is n o increased risk for patients receiving repetetive infusions of FCM. This 
is somewhat the opposite of what is believed to be true and ,hence, the text should therefor be 
more specific in this regard.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls  are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
 
 
 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financi ally from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organiz ation that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of th e above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I report no changes since my last declaration from the first review of this paper.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under  an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be pu blished.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Hypophosphataemia after ferric carboxymaltose is un related to symptoms, intestinal 
inflammation or vitamin D status  
 
Version: 1 Date: 13 Mar 2020  
 
Reviewer: Trond Espen Detlie  
 
Reviewer's report:  
 
Congratulations on a nice paper.  
 
I still feel that my comment related to line 239 -246 in the previous version, now line 197 -204 in 
the current ver sion, is relevant. However, if the authors choose to keep this section I would 
recommend to specify how many of the 5 patients had received FCM within the last 6 months 
and make a comment on if any of the patients had a state of hypophosphatemia at inclusi on of 
this study. The theory of an additive effect of repetitive infusions of FCM is that the patients 
have not had the time to normalize their blood values before the next infusion. This includes 
phosphate, iFGF23, PTH, ionized calcium, Vitamin d etc. Sin ce there is no good data (except for 
some case reports) on a prolonged effect beyond 6 months I feel this needs to be addressed when 
using a timeline of 12 months in this section. The way it is now phrased might give a misleading 
impression that there is n o increased risk for patients receiving repetetive infusions of FCM. This 
is somewhat the opposite of what is believed to be true and ,hence, the text should therefor be 
more specific in this regard.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls  are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
 
 
 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financi ally from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organiz ation that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of th e above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I report no changes since my last declaration from the first review of this paper.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under  an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be pu blished.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Hypophosphataemia after ferric carboxymaltose is un related to symptoms, intestinal 
inflammation or vitamin D status  
 
Version: 1 Date: 13 Mar 2020  
 
Reviewer: Trond Espen Detlie  
 
Reviewer's report:  
 
Congratulations on a nice paper.  
 
I still feel that my comment related to line 239 -246 in the previous version, now line 197 -204 in 
the current ver sion, is relevant. However, if the authors choose to keep this section I would 
recommend to specify how many of the 5 patients had received FCM within the last 6 months 
and make a comment on if any of the patients had a state of hypophosphatemia at inclusi on of 
this study. The theory of an additive effect of repetitive infusions of FCM is that the patients 
have not had the time to normalize their blood values before the next infusion. This includes 
phosphate, iFGF23, PTH, ionized calcium, Vitamin d etc. Sin ce there is no good data (except for 
some case reports) on a prolonged effect beyond 6 months I feel this needs to be addressed when 
using a timeline of 12 months in this section. The way it is now phrased might give a misleading 
impression that there is n o increased risk for patients receiving repetetive infusions of FCM. This 
is somewhat the opposite of what is believed to be true and ,hence, the text should therefor be 
more specific in this regard.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls  are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
 
 
 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financi ally from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organiz ation that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of th e above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I report no changes since my last declaration from the first review of this paper.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under  an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be pu blished.  
 
I agree to the open peer review policy of the journal  
assistant