Title: Can Visceral Adipose Tissue and Skeletal Muscle PredictRecurrence of Newly Diagnosed
Crohn’s Disease in Different Treatments
Version: 6 Date: 04 Mar 2022
Reviewer's report:
I re-reviewed the munascript as below;
Author concluded that the visceral adipose tissue (VAT) and skeletal muscle (SM) were
associated with the recurrence within one year for Crohn’s disease (CD) patients treated by 5-
amino salicylic (5-ASA) or azathioprine + steroids, but not in biologics.
1, How the meaning or usefulness of this measurement in clinical setting? We do not think 5-
ASA is the useful treatment in CD as you do think (nearly fifty percent of effectiveness) because
the patient we are seeing has many refractoriness.
2, CD is treated as stepwise way as you agree; 5-ASA is the first choice then to steroid is the
second choice and biologics is the final or third step. I think author has selected treatments as
your guideline recommends.
As retrospective study has to setup or build firm cohorts in a proper timeline as due. In this
study old cohort (2015-) was treated and then changed to be second group, and in the era of
biologics (2019-) the third cohort was set up. Were they treated with double or triple regimens
(5-ASA at first and covered with steroid second and then biologics added)? In other words, did
patients treated by biologics have a history of 5-ASA treatment or steroid treatment? If it is right
several cohorts have different background refractoriness because disease course progressed and
several attacks experienced then the intestinal wall will be thickened and increased stiffness
by continued inflammation. Does author think your cohorts are comparable and completely
different? Did they have continuity in timeline?
3, Finally does author think VAT measured in this study was useful in only the first attack of
CD but was not useful after several attack of CD in predicting effectiveness?
4, VAT and SM should be measured before and after treatment because these parameters are
presumed to be changeable and then true prediction or feasibility of VAT will be demonstrated.
Title: Can Visceral Adipose Tissue and Skeletal Muscle PredictRecurrence of Newly Diagnosed
Crohn’s Disease in Different Treatments
Version: 6 Date: 04 Mar 2022
Reviewer's report:
I re-reviewed the munascript as below;
Author concluded that the visceral adipose tissue (VAT) and skeletal muscle (SM) were
associated with the recurrence within one year for Crohn’s disease (CD) patients treated by 5-
amino salicylic (5-ASA) or azathioprine + steroids, but not in biologics.
1, How the meaning or usefulness of this measurement in clinical setting? We do not think 5-
ASA is the useful treatment in CD as you do think (nearly fifty percent of effectiveness) because
the patient we are seeing has many refractoriness.
2, CD is treated as stepwise way as you agree; 5-ASA is the first choice then to steroid is the
second choice and biologics is the final or third step. I think author has selected treatments as
your guideline recommends.
As retrospective study has to setup or build firm cohorts in a proper timeline as due. In this
study old cohort (2015-) was treated and then changed to be second group, and in the era of
biologics (2019-) the third cohort was set up. Were they treated with double or triple regimens
(5-ASA at first and covered with steroid second and then biologics added)? In other words, did
patients treated by biologics have a history of 5-ASA treatment or steroid treatment? If it is right
several cohorts have different background refractoriness because disease course progressed and
several attacks experienced then the intestinal wall will be thickened and increased stiffness
by continued inflammation. Does author think your cohorts are comparable and completely
different? Did they have continuity in timeline?
3, Finally does author think VAT measured in this study was useful in only the first attack of
CD but was not useful after several attack of CD in predicting effectiveness?
4, VAT and SM should be measured before and after treatment because these parameters are
presumed to be changeable and then true prediction or feasibility of VAT will be demonstrated.
Please review this paper.
user
Title: Can Visceral Adipose Tissue and Skeletal Muscle PredictRecurrence of Newly Diagnosed
Crohn’s Disease in Different Treatments
Version: 6 Date: 04 Mar 2022
Reviewer's report:
I re-reviewed the munascript as below;
Author concluded that the visceral adipose tissue (VAT) and skeletal muscle (SM) were
associated with the recurrence within one year for Crohn’s disease (CD) patients treated by 5-
amino salicylic (5-ASA) or azathioprine + steroids, but not in biologics.
1, How the meaning or usefulness of this measurement in clinical setting? We do not think 5-
ASA is the useful treatment in CD as you do think (nearly fifty percent of effectiveness) because
the patient we are seeing has many refractoriness.
2, CD is treated as stepwise way as you agree; 5-ASA is the first choice then to steroid is the
second choice and biologics is the final or third step. I think author has selected treatments as
your guideline recommends.
As retrospective study has to setup or build firm cohorts in a proper timeline as due. In this
study old cohort (2015-) was treated and then changed to be second group, and in the era of
biologics (2019-) the third cohort was set up. Were they treated with double or triple regimens
(5-ASA at first and covered with steroid second and then biologics added)? In other words, did
patients treated by biologics have a history of 5-ASA treatment or steroid treatment? If it is right
several cohorts have different background refractoriness because disease course progressed and
several attacks experienced then the intestinal wall will be thickened and increased stiffness
by continued inflammation. Does author think your cohorts are comparable and completely
different? Did they have continuity in timeline?
3, Finally does author think VAT measured in this study was useful in only the first attack of
CD but was not useful after several attack of CD in predicting effectiveness?
4, VAT and SM should be measured before and after treatment because these parameters are
presumed to be changeable and then true prediction or feasibility of VAT will be demonstrated.
assistant