Reviewer's report
Title:Clinical characteristics of elderly patients with proton pump
inhibitor-refractory non-erosive reflux disease from the G-PRIDE study who
responded to rikkunshito
Version:2Date:6 May 2014
Reviewer: Kunihiko Aoyagi
Reviewer's report:
The previous G-PRIDE study showed that rikkunshito (RKT) may be useful for
improving mental quality of life and dyspeptic symptoms in patients with
PPI-refractory NERD, particularly for elderly and female patients (J Gastroenterol
2014). To evaluate clinical characteristics of elderly PPI-refractory NERD patients
with ARD symptoms who responded to RKT (RKT), in the present study, the
authors analyzed elderly patients with 1 or more FSSG out of the previous
G-PRIDE study. Combination therapy with RKT (RKT group) for 8 weeks showed
significant improvement in 3 subscale scores (abdominal bloating, heavy feeling
in stomach after meals, and sick feeling after meals) of the ARD domain and 1
subscale score (heartburn after meals) of the reflux symptom domain. From
these data, they concluded that RKT was particularly effective for resolving
postprandial GERD symptoms (heavy feeling in stomach after meals, sick feeling
after meals, and heartburn after meals) in elderly PPI-refractory NERD patients
with ARD.
Major
However, it is well known that the symptoms of postprandial distress syndrome
and epigastric pain syndrome, the two subtypes of functional dyspepsia under
the new Rome III classification, tend to overlap with those of NERD (Shindo T,
Digestion. 2009;79:65-72).
Although dyspeptic and IBS-like complaints overlap with GERD symptoms as
mentioned in the discussion, it seems difficult whether patients in this study are
diagnosed as having PPI-refractory NERD or functional dyspepsia. Is this cohort
appropriate for the trial that characterize the elderly PPI-refractory NERD patients
who respond to RKT?
To clarify clinical characteristics of elderly PPI-refractory NERD patients who
responded to RKT, the authors should demonstrate the differences in clinical
characteristics between the RKT responsive group and nonresponsive group. In
this respect, this manuscript has insufficient data to achieve the aims.
Minor
Exactly the same sentences in the discussion are seen as in the previous similar
study (J Gastroenterol 2014).
Level of interest: An article of importance in its field
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:Clinical characteristics of elderly patients with proton pump
inhibitor-refractory non-erosive reflux disease from the G-PRIDE study who
responded to rikkunshito
Version:2Date:6 May 2014
Reviewer: Kunihiko Aoyagi
Reviewer's report:
The previous G-PRIDE study showed that rikkunshito (RKT) may be useful for
improving mental quality of life and dyspeptic symptoms in patients with
PPI-refractory NERD, particularly for elderly and female patients (J Gastroenterol
2014). To evaluate clinical characteristics of elderly PPI-refractory NERD patients
with ARD symptoms who responded to RKT (RKT), in the present study, the
authors analyzed elderly patients with 1 or more FSSG out of the previous
G-PRIDE study. Combination therapy with RKT (RKT group) for 8 weeks showed
significant improvement in 3 subscale scores (abdominal bloating, heavy feeling
in stomach after meals, and sick feeling after meals) of the ARD domain and 1
subscale score (heartburn after meals) of the reflux symptom domain. From
these data, they concluded that RKT was particularly effective for resolving
postprandial GERD symptoms (heavy feeling in stomach after meals, sick feeling
after meals, and heartburn after meals) in elderly PPI-refractory NERD patients
with ARD.
Major
However, it is well known that the symptoms of postprandial distress syndrome
and epigastric pain syndrome, the two subtypes of functional dyspepsia under
the new Rome III classification, tend to overlap with those of NERD (Shindo T,
Digestion. 2009;79:65-72).
Although dyspeptic and IBS-like complaints overlap with GERD symptoms as
mentioned in the discussion, it seems difficult whether patients in this study are
diagnosed as having PPI-refractory NERD or functional dyspepsia. Is this cohort
appropriate for the trial that characterize the elderly PPI-refractory NERD patients
who respond to RKT?
To clarify clinical characteristics of elderly PPI-refractory NERD patients who
responded to RKT, the authors should demonstrate the differences in clinical
characteristics between the RKT responsive group and nonresponsive group. In
this respect, this manuscript has insufficient data to achieve the aims.
Minor
Exactly the same sentences in the discussion are seen as in the previous similar
study (J Gastroenterol 2014).
Level of interest: An article of importance in its field
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:Clinical characteristics of elderly patients with proton pump
inhibitor-refractory non-erosive reflux disease from the G-PRIDE study who
responded to rikkunshito
Version:2Date:6 May 2014
Reviewer: Kunihiko Aoyagi
Reviewer's report:
The previous G-PRIDE study showed that rikkunshito (RKT) may be useful for
improving mental quality of life and dyspeptic symptoms in patients with
PPI-refractory NERD, particularly for elderly and female patients (J Gastroenterol
2014). To evaluate clinical characteristics of elderly PPI-refractory NERD patients
with ARD symptoms who responded to RKT (RKT), in the present study, the
authors analyzed elderly patients with 1 or more FSSG out of the previous
G-PRIDE study. Combination therapy with RKT (RKT group) for 8 weeks showed
significant improvement in 3 subscale scores (abdominal bloating, heavy feeling
in stomach after meals, and sick feeling after meals) of the ARD domain and 1
subscale score (heartburn after meals) of the reflux symptom domain. From
these data, they concluded that RKT was particularly effective for resolving
postprandial GERD symptoms (heavy feeling in stomach after meals, sick feeling
after meals, and heartburn after meals) in elderly PPI-refractory NERD patients
with ARD.
Major
However, it is well known that the symptoms of postprandial distress syndrome
and epigastric pain syndrome, the two subtypes of functional dyspepsia under
the new Rome III classification, tend to overlap with those of NERD (Shindo T,
Digestion. 2009;79:65-72).
Although dyspeptic and IBS-like complaints overlap with GERD symptoms as
mentioned in the discussion, it seems difficult whether patients in this study are
diagnosed as having PPI-refractory NERD or functional dyspepsia. Is this cohort
appropriate for the trial that characterize the elderly PPI-refractory NERD patients
who respond to RKT?
To clarify clinical characteristics of elderly PPI-refractory NERD patients who
responded to RKT, the authors should demonstrate the differences in clinical
characteristics between the RKT responsive group and nonresponsive group. In
this respect, this manuscript has insufficient data to achieve the aims.
Minor
Exactly the same sentences in the discussion are seen as in the previous similar
study (J Gastroenterol 2014).
Level of interest: An article of importance in its field
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