Reviewer's report
Title:Treatment of children and adolescents with ulcerative colitis by adsorptive
depletion of myeloid lineage leucocytes as monotherapy or in combination with
low dose prednisolone after failure of first-line medications
Version: 3Date:10 July 2013
Reviewer: Anastasia Konidari
Reviewer's report:
Minor essential reviews
Version 2 is much improved.
More emphasis however needs to be given to the limitations of this review due to
the small and highly selected sample size, which does not allow for
generalisation of conclusions, unless further double blinded randomised
controlled trials can be conducted.
Furthermore,it would be essential to have a fourth group of patients who have
had corticosteroids for induction of remission, so as to directly assess superiority
of GMA over a recognised first line treatment for induction of remission.
As no such comparison has been carried out, the superiority of induction of
remission with GMA treatment must not be inferred and will remain doubtful. The
last sentence in the conclusions section of the abstract needs therefore to be
amended and this change should be reflected within the body of the manuscript.
Clearly a number of patients with higher CAI score required adjunct therapy with
corticosteroids to go into remission; how long is it ethical to wait until adding
corticosteroids to GMA treatment, in case of suboptimal response to this
treatment or increased disease activity? How was the time point, at which
corticosteroid treatment was added to one of the three groups in the study,
decided? Compared groups had differences in disease severity, therefore validity
of conclusions drawn about superiority of GMA over pharmacotherapy may be
weak unless further research is conducted.
Finally, although the maintenance of remission was not the objective of this
study, it is of high clinical importance to assess how GMA treatment for induction
of remission may affect disease course in short to medium term at least.
Please note last sentence in 'subgroup analyses' section;it should read 'score'
not 'core'.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Treatment of children and adolescents with ulcerative colitis by adsorptive
depletion of myeloid lineage leucocytes as monotherapy or in combination with
low dose prednisolone after failure of first-line medications
Version: 3Date:10 July 2013
Reviewer: Anastasia Konidari
Reviewer's report:
Minor essential reviews
Version 2 is much improved.
More emphasis however needs to be given to the limitations of this review due to
the small and highly selected sample size, which does not allow for
generalisation of conclusions, unless further double blinded randomised
controlled trials can be conducted.
Furthermore,it would be essential to have a fourth group of patients who have
had corticosteroids for induction of remission, so as to directly assess superiority
of GMA over a recognised first line treatment for induction of remission.
As no such comparison has been carried out, the superiority of induction of
remission with GMA treatment must not be inferred and will remain doubtful. The
last sentence in the conclusions section of the abstract needs therefore to be
amended and this change should be reflected within the body of the manuscript.
Clearly a number of patients with higher CAI score required adjunct therapy with
corticosteroids to go into remission; how long is it ethical to wait until adding
corticosteroids to GMA treatment, in case of suboptimal response to this
treatment or increased disease activity? How was the time point, at which
corticosteroid treatment was added to one of the three groups in the study,
decided? Compared groups had differences in disease severity, therefore validity
of conclusions drawn about superiority of GMA over pharmacotherapy may be
weak unless further research is conducted.
Finally, although the maintenance of remission was not the objective of this
study, it is of high clinical importance to assess how GMA treatment for induction
of remission may affect disease course in short to medium term at least.
Please note last sentence in 'subgroup analyses' section;it should read 'score'
not 'core'.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Treatment of children and adolescents with ulcerative colitis by adsorptive
depletion of myeloid lineage leucocytes as monotherapy or in combination with
low dose prednisolone after failure of first-line medications
Version: 3Date:10 July 2013
Reviewer: Anastasia Konidari
Reviewer's report:
Minor essential reviews
Version 2 is much improved.
More emphasis however needs to be given to the limitations of this review due to
the small and highly selected sample size, which does not allow for
generalisation of conclusions, unless further double blinded randomised
controlled trials can be conducted.
Furthermore,it would be essential to have a fourth group of patients who have
had corticosteroids for induction of remission, so as to directly assess superiority
of GMA over a recognised first line treatment for induction of remission.
As no such comparison has been carried out, the superiority of induction of
remission with GMA treatment must not be inferred and will remain doubtful. The
last sentence in the conclusions section of the abstract needs therefore to be
amended and this change should be reflected within the body of the manuscript.
Clearly a number of patients with higher CAI score required adjunct therapy with
corticosteroids to go into remission; how long is it ethical to wait until adding
corticosteroids to GMA treatment, in case of suboptimal response to this
treatment or increased disease activity? How was the time point, at which
corticosteroid treatment was added to one of the three groups in the study,
decided? Compared groups had differences in disease severity, therefore validity
of conclusions drawn about superiority of GMA over pharmacotherapy may be
weak unless further research is conducted.
Finally, although the maintenance of remission was not the objective of this
study, it is of high clinical importance to assess how GMA treatment for induction
of remission may affect disease course in short to medium term at least.
Please note last sentence in 'subgroup analyses' section;it should read 'score'
not 'core'.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
assistant