Title: A retrospective, observational study to examine the effect of early tumor necrosis factor
inhibitor use on rates of surgery for Crohn’s disease in Japan
Version: 2 Date: 26 Jul 2024
Reviewer:  Milan Lukas
Reviewer's report:
I have read this manuscript entitled: „A retrospective, observational study to examine the effect
of early tumor necrosis factor inhibitor use of rates of surgery for Crohn´s disease in Japan“
with great interest. In the literature we have  convincing data, that biological anti-TNF therapy
is associated with lower risk of surgery comparing the standard (conventional) therapy in
patients with Crohn´s  disease. We also have  some data showing  that early therapy which is
introduced in Crohn´s disease patients shortly after diagnosis (less two years) is more effective
than biological therapy  in patients with long-term  duration of Crohn´ s disease (more than five
years period). This manuscript summarize the results of the first study from Japan. Results of
these retrospective analysis  support these evidence. Authors retrospectively compared patients
with Crohn´s disease those have been exposed to  infliximab or adalimumab (86 patients) with
patients wihout exposition to biological therapy.  Results retrospective analysis clearly showed
that  significantly lower proportion of patients on biological therapy required surgery (3/86)
compaing with cohort of patients on conventional therapy (17/38);  the cummulative surgery
free survival time was significantly higher on biological cohort comparing with patients on
conventional therapy; median time to surgery was significantly longer in those patients exposed
to biologicals comparing with non-biological cohort.
Interesting study where two minor drawbaks seems to me:
• Very low number of patients  those underwent surgery (3/86) precluding efficacy comparison
between infliximab (1) and adalimumab (2) and this part should be be removed
• Different median of observational time in those patients exposed and unexposed to biologicals
(4.62 years  vs 8.13 years) have had impact on higher proportion of patients underwent surgery
with longer observational period. This topic should be mentioned in discussion.
Title: A retrospective, observational study to examine the effect of early tumor necrosis factor
inhibitor use on rates of surgery for Crohn’s disease in Japan
Version: 2 Date: 26 Jul 2024
Reviewer:  Milan Lukas
Reviewer's report:
I have read this manuscript entitled: „A retrospective, observational study to examine the effect
of early tumor necrosis factor inhibitor use of rates of surgery for Crohn´s disease in Japan“
with great interest. In the literature we have  convincing data, that biological anti-TNF therapy
is associated with lower risk of surgery comparing the standard (conventional) therapy in
patients with Crohn´s  disease. We also have  some data showing  that early therapy which is
introduced in Crohn´s disease patients shortly after diagnosis (less two years) is more effective
than biological therapy  in patients with long-term  duration of Crohn´ s disease (more than five
years period). This manuscript summarize the results of the first study from Japan. Results of
these retrospective analysis  support these evidence. Authors retrospectively compared patients
with Crohn´s disease those have been exposed to  infliximab or adalimumab (86 patients) with
patients wihout exposition to biological therapy.  Results retrospective analysis clearly showed
that  significantly lower proportion of patients on biological therapy required surgery (3/86)
compaing with cohort of patients on conventional therapy (17/38);  the cummulative surgery
free survival time was significantly higher on biological cohort comparing with patients on
conventional therapy; median time to surgery was significantly longer in those patients exposed
to biologicals comparing with non-biological cohort.
Interesting study where two minor drawbaks seems to me:
• Very low number of patients  those underwent surgery (3/86) precluding efficacy comparison
between infliximab (1) and adalimumab (2) and this part should be be removed
• Different median of observational time in those patients exposed and unexposed to biologicals
(4.62 years  vs 8.13 years) have had impact on higher proportion of patients underwent surgery
with longer observational period. This topic should be mentioned in discussion.
Please review this paper.
user
Title: A retrospective, observational study to examine the effect of early tumor necrosis factor
inhibitor use on rates of surgery for Crohn’s disease in Japan
Version: 2 Date: 26 Jul 2024
Reviewer:  Milan Lukas
Reviewer's report:
I have read this manuscript entitled: „A retrospective, observational study to examine the effect
of early tumor necrosis factor inhibitor use of rates of surgery for Crohn´s disease in Japan“
with great interest. In the literature we have  convincing data, that biological anti-TNF therapy
is associated with lower risk of surgery comparing the standard (conventional) therapy in
patients with Crohn´s  disease. We also have  some data showing  that early therapy which is
introduced in Crohn´s disease patients shortly after diagnosis (less two years) is more effective
than biological therapy  in patients with long-term  duration of Crohn´ s disease (more than five
years period). This manuscript summarize the results of the first study from Japan. Results of
these retrospective analysis  support these evidence. Authors retrospectively compared patients
with Crohn´s disease those have been exposed to  infliximab or adalimumab (86 patients) with
patients wihout exposition to biological therapy.  Results retrospective analysis clearly showed
that  significantly lower proportion of patients on biological therapy required surgery (3/86)
compaing with cohort of patients on conventional therapy (17/38);  the cummulative surgery
free survival time was significantly higher on biological cohort comparing with patients on
conventional therapy; median time to surgery was significantly longer in those patients exposed
to biologicals comparing with non-biological cohort.
Interesting study where two minor drawbaks seems to me:
• Very low number of patients  those underwent surgery (3/86) precluding efficacy comparison
between infliximab (1) and adalimumab (2) and this part should be be removed
• Different median of observational time in those patients exposed and unexposed to biologicals
(4.62 years  vs 8.13 years) have had impact on higher proportion of patients underwent surgery
with longer observational period. This topic should be mentioned in discussion.
assistant