Title: Vedolizumab–steroid combination therapy improves long-term prognosis in patients with
ulcerative colitis
Version: 1 Date: 29 Jan 2025
Reviewer's report:
This is an interesting study evaluating the impact of vedolizumab and steroid combination
therapy in patients with ulcerative colitis. The real-world data approach provides valuable
insight into treatment strategies beyond clinical trials, and the findings on early steroid induction
could be clinically relevant. The study is well-structured, and the statistical analysis appears
appropriate.
However, there are a few limitations that should be addressed to strengthen the manuscript:
Sample Size: The study includes only 38 patients, which is relatively small for drawing robust
conclusions. Given the inherent variability in real-world data, a larger cohort would enhance the
reliability and generalizability of the findings.
Selection Bias: The inclusion criteria may have introduced a bias, as patients with more severe
disease are more likely to receive higher doses of steroids in the induction phase. This may
overestimate the short-term efficacy of the combination therapy. Addressing this limitation in
the discussion would be helpful.
Established Efficacy of Vedolizumab: The short-term and long-term efficacy of vedolizumab
for ulcerative colitis has been well-documented in previous randomized controlled trials. While
this study provides real-world data, the novelty of the findings should be clearly distinguished
from prior evidence. Emphasizing how the study adds to existing knowledge could strengthen
its impact.
Lack of Endoscopic Outcomes: The study primarily relies on clinical indices and CRP levels
but lacks endoscopic outcomes, which are crucial for assessing mucosal healing. Given that
vedolizumab has been shown to improve endoscopic healing, incorporating or discussing
endoscopic data would enhance the clinical relevance of the findings.
Overall, this study provides useful insights into the potential benefits of early steroid
combination with vedolizumab. Addressing the above concerns will further strengthen the
manuscript and improve its contribution to the field.
Title: Vedolizumab–steroid combination therapy improves long-term prognosis in patients with
ulcerative colitis
Version: 1 Date: 29 Jan 2025
Reviewer's report:
This is an interesting study evaluating the impact of vedolizumab and steroid combination
therapy in patients with ulcerative colitis. The real-world data approach provides valuable
insight into treatment strategies beyond clinical trials, and the findings on early steroid induction
could be clinically relevant. The study is well-structured, and the statistical analysis appears
appropriate.
However, there are a few limitations that should be addressed to strengthen the manuscript:
Sample Size: The study includes only 38 patients, which is relatively small for drawing robust
conclusions. Given the inherent variability in real-world data, a larger cohort would enhance the
reliability and generalizability of the findings.
Selection Bias: The inclusion criteria may have introduced a bias, as patients with more severe
disease are more likely to receive higher doses of steroids in the induction phase. This may
overestimate the short-term efficacy of the combination therapy. Addressing this limitation in
the discussion would be helpful.
Established Efficacy of Vedolizumab: The short-term and long-term efficacy of vedolizumab
for ulcerative colitis has been well-documented in previous randomized controlled trials. While
this study provides real-world data, the novelty of the findings should be clearly distinguished
from prior evidence. Emphasizing how the study adds to existing knowledge could strengthen
its impact.
Lack of Endoscopic Outcomes: The study primarily relies on clinical indices and CRP levels
but lacks endoscopic outcomes, which are crucial for assessing mucosal healing. Given that
vedolizumab has been shown to improve endoscopic healing, incorporating or discussing
endoscopic data would enhance the clinical relevance of the findings.
Overall, this study provides useful insights into the potential benefits of early steroid
combination with vedolizumab. Addressing the above concerns will further strengthen the
manuscript and improve its contribution to the field.
Please review this paper.
user
Title: Vedolizumab–steroid combination therapy improves long-term prognosis in patients with
ulcerative colitis
Version: 1 Date: 29 Jan 2025
Reviewer's report:
This is an interesting study evaluating the impact of vedolizumab and steroid combination
therapy in patients with ulcerative colitis. The real-world data approach provides valuable
insight into treatment strategies beyond clinical trials, and the findings on early steroid induction
could be clinically relevant. The study is well-structured, and the statistical analysis appears
appropriate.
However, there are a few limitations that should be addressed to strengthen the manuscript:
Sample Size: The study includes only 38 patients, which is relatively small for drawing robust
conclusions. Given the inherent variability in real-world data, a larger cohort would enhance the
reliability and generalizability of the findings.
Selection Bias: The inclusion criteria may have introduced a bias, as patients with more severe
disease are more likely to receive higher doses of steroids in the induction phase. This may
overestimate the short-term efficacy of the combination therapy. Addressing this limitation in
the discussion would be helpful.
Established Efficacy of Vedolizumab: The short-term and long-term efficacy of vedolizumab
for ulcerative colitis has been well-documented in previous randomized controlled trials. While
this study provides real-world data, the novelty of the findings should be clearly distinguished
from prior evidence. Emphasizing how the study adds to existing knowledge could strengthen
its impact.
Lack of Endoscopic Outcomes: The study primarily relies on clinical indices and CRP levels
but lacks endoscopic outcomes, which are crucial for assessing mucosal healing. Given that
vedolizumab has been shown to improve endoscopic healing, incorporating or discussing
endoscopic data would enhance the clinical relevance of the findings.
Overall, this study provides useful insights into the potential benefits of early steroid
combination with vedolizumab. Addressing the above concerns will further strengthen the
manuscript and improve its contribution to the field.
assistant