Title: Anti-TNF therapy for Ulcerative Colitis in Brazil: a comparative real-world national
retrospective multicentric study from the Brazilian Study Group of IBD (GEDIIB)
Version: 2 Date: 12 Feb 2022
Reviewer's report:
The authors compared the efficacy and safety of IFX and ADA in a retrospective multicentre
study in Brazil and concluded that IFX has better long-term efficacy. Unfortunately, a number
of methodological errors make it difficult to assess whether the results are correct.
-Since the authors are described as moderate-to-severe UC in Abstract and Methods, it is
inconsistent that the patients with remission to mild patients were included in table 1 . In addition,
the inclusion of a case with an MES of 0 suggests the use of TNF-a agents for extra-intestinal
complications. The use of TNF-a agents for extra-intestinal complications should be excluded
when looking at intestinal symptoms in the first place.
-Figure 1 would be easier to understand if a time series including baseline and week 8 were
shown.
-Efforts should be made to reduce the bias, e.g. propensity score matching, multivariable analysis
using appropriate variants.
-Baseline severity and smoking are not included in the multivariate analysis. On the contrary, it
is strange to adjust for efficacy at 8 and 26 weeks and endoscopic remission.
-There is a lack of how missing values are handled in Methods; more than 20% of cases in each
of the IFX and ADA groups are excluded, which is likely to result in large bias; Patient flow
should be clarified and the authors should consider how missing values occur in each category.
-The conclusion is too long.
Title: Anti-TNF therapy for Ulcerative Colitis in Brazil: a comparative real-world national
retrospective multicentric study from the Brazilian Study Group of IBD (GEDIIB)
Version: 2 Date: 12 Feb 2022
Reviewer's report:
The authors compared the efficacy and safety of IFX and ADA in a retrospective multicentre
study in Brazil and concluded that IFX has better long-term efficacy. Unfortunately, a number
of methodological errors make it difficult to assess whether the results are correct.
-Since the authors are described as moderate-to-severe UC in Abstract and Methods, it is
inconsistent that the patients with remission to mild patients were included in table 1 . In addition,
the inclusion of a case with an MES of 0 suggests the use of TNF-a agents for extra-intestinal
complications. The use of TNF-a agents for extra-intestinal complications should be excluded
when looking at intestinal symptoms in the first place.
-Figure 1 would be easier to understand if a time series including baseline and week 8 were
shown.
-Efforts should be made to reduce the bias, e.g. propensity score matching, multivariable analysis
using appropriate variants.
-Baseline severity and smoking are not included in the multivariate analysis. On the contrary, it
is strange to adjust for efficacy at 8 and 26 weeks and endoscopic remission.
-There is a lack of how missing values are handled in Methods; more than 20% of cases in each
of the IFX and ADA groups are excluded, which is likely to result in large bias; Patient flow
should be clarified and the authors should consider how missing values occur in each category.
-The conclusion is too long.
Please review this paper.
user
Title: Anti-TNF therapy for Ulcerative Colitis in Brazil: a comparative real-world national
retrospective multicentric study from the Brazilian Study Group of IBD (GEDIIB)
Version: 2 Date: 12 Feb 2022
Reviewer's report:
The authors compared the efficacy and safety of IFX and ADA in a retrospective multicentre
study in Brazil and concluded that IFX has better long-term efficacy. Unfortunately, a number
of methodological errors make it difficult to assess whether the results are correct.
-Since the authors are described as moderate-to-severe UC in Abstract and Methods, it is
inconsistent that the patients with remission to mild patients were included in table 1 . In addition,
the inclusion of a case with an MES of 0 suggests the use of TNF-a agents for extra-intestinal
complications. The use of TNF-a agents for extra-intestinal complications should be excluded
when looking at intestinal symptoms in the first place.
-Figure 1 would be easier to understand if a time series including baseline and week 8 were
shown.
-Efforts should be made to reduce the bias, e.g. propensity score matching, multivariable analysis
using appropriate variants.
-Baseline severity and smoking are not included in the multivariate analysis. On the contrary, it
is strange to adjust for efficacy at 8 and 26 weeks and endoscopic remission.
-There is a lack of how missing values are handled in Methods; more than 20% of cases in each
of the IFX and ADA groups are excluded, which is likely to result in large bias; Patient flow
should be clarified and the authors should consider how missing values occur in each category.
-The conclusion is too long.
assistant