Title: Efficacy of Crohn's Disease Exclusion Diet in Treatment -naïve Children and Children
Progressed on Biological Therapy: A Retrospective Chart Review
Version: 1 Date: 08 May 2023
Reviewer's report:
In this case series, María Clara Jijón Andrade, et al. reported their experience with the outcomes
of Crohn’s disease exclusion diet (CDED) plus partial enteral nutrition (PEN) in the paediatric-
onset CD at disease onset and after the loss of response to biologics. They conclude that treatment
with CDED plus PEN was well tolerated and achieved an excellent clinical remission rate in
treatment-naive patients. The benefit was less in patients who initiated the strategy after losing
the response to biologics. The study question is valid and very relevant in clinical practice.
However, the study is limited by small sample size and absence of endoscopic information as
mentioned by the authors.
The manuscript can be improved by addressing the following concerns.
- Consider revising the introduction section to include more details on CDED. It currently
focuses more on CD than CDED.
- Include baseline values for calprotectin, ESR, CRP, Albumin, Hb and iron level for both groups
in Table 1.
- Authors found that CRP and Wt Z-score did not show significant improvement despite
significant improvement in other parameters. Authors may want explain why no improvement
was noticed in these parameters in the discussion section.
- Consider performing univariate/multivariate analysis to find out which variables are associated
with remission in both groups (variables like age, sex, medications, location of CD, behavior of
CD, duration of disease and other relevant variables can be studies).
Title: Efficacy of Crohn's Disease Exclusion Diet in Treatment -naïve Children and Children
Progressed on Biological Therapy: A Retrospective Chart Review
Version: 1 Date: 08 May 2023
Reviewer's report:
In this case series, María Clara Jijón Andrade, et al. reported their experience with the outcomes
of Crohn’s disease exclusion diet (CDED) plus partial enteral nutrition (PEN) in the paediatric-
onset CD at disease onset and after the loss of response to biologics. They conclude that treatment
with CDED plus PEN was well tolerated and achieved an excellent clinical remission rate in
treatment-naive patients. The benefit was less in patients who initiated the strategy after losing
the response to biologics. The study question is valid and very relevant in clinical practice.
However, the study is limited by small sample size and absence of endoscopic information as
mentioned by the authors.
The manuscript can be improved by addressing the following concerns.
- Consider revising the introduction section to include more details on CDED. It currently
focuses more on CD than CDED.
- Include baseline values for calprotectin, ESR, CRP, Albumin, Hb and iron level for both groups
in Table 1.
- Authors found that CRP and Wt Z-score did not show significant improvement despite
significant improvement in other parameters. Authors may want explain why no improvement
was noticed in these parameters in the discussion section.
- Consider performing univariate/multivariate analysis to find out which variables are associated
with remission in both groups (variables like age, sex, medications, location of CD, behavior of
CD, duration of disease and other relevant variables can be studies).
Please review this paper.
user
Title: Efficacy of Crohn's Disease Exclusion Diet in Treatment -naïve Children and Children
Progressed on Biological Therapy: A Retrospective Chart Review
Version: 1 Date: 08 May 2023
Reviewer's report:
In this case series, María Clara Jijón Andrade, et al. reported their experience with the outcomes
of Crohn’s disease exclusion diet (CDED) plus partial enteral nutrition (PEN) in the paediatric-
onset CD at disease onset and after the loss of response to biologics. They conclude that treatment
with CDED plus PEN was well tolerated and achieved an excellent clinical remission rate in
treatment-naive patients. The benefit was less in patients who initiated the strategy after losing
the response to biologics. The study question is valid and very relevant in clinical practice.
However, the study is limited by small sample size and absence of endoscopic information as
mentioned by the authors.
The manuscript can be improved by addressing the following concerns.
- Consider revising the introduction section to include more details on CDED. It currently
focuses more on CD than CDED.
- Include baseline values for calprotectin, ESR, CRP, Albumin, Hb and iron level for both groups
in Table 1.
- Authors found that CRP and Wt Z-score did not show significant improvement despite
significant improvement in other parameters. Authors may want explain why no improvement
was noticed in these parameters in the discussion section.
- Consider performing univariate/multivariate analysis to find out which variables are associated
with remission in both groups (variables like age, sex, medications, location of CD, behavior of
CD, duration of disease and other relevant variables can be studies).
assistant