Title: Superior Persistence of Ustekinumab Compared to Anti-TNF in Vedolizumab-
Experienced Inflammatory Bowel Diseases Patients: A Real- world Cohort Study
Version: 1 Date: 27 Sep 2024
Reviewer's report:
Thank you for the invitation to review the manuscript by Horng-Yih Chiu et al entitled " Superior
Persistence of Ustekinumab Compared to Anti-TNF in Vedolizumab-Experienced Inflammatory
Bowel Diseases Patients: A Real-world Cohort Study”.
Horng-Yih Chiu et al performed a retrospective analysis on the persistence of UST vs anti-TNF
amongst IBD patients after VDZ failure. The topic is interesting. The paper is well-written, here
are some comments that suggested to be clarified in a revised version of the manuscript:
• Were other anti-TNF agents (golimumab, certolizumab) used?
• Please define catastrophic illness in Methods
• Was IFX dose escalation (to 10 mg pro kg) allowed?
• How was uni- and multivariable (multivariate?) models handled? Please specify model
selection.
• The high persistence rate of UST is interesting but needs explanation. Why was IFX dose
escalation rate lower than UST while the persistence was higher? Were these cases due to allergy
or PNR or something else? You state that the most frequent cause of failure was secondary loss
of response. Please comment.
• Is it available to use VDZ as first line in general in your center? If yes, please comment it, if no
please describe patient population in more details regarding comorbidities and other influencing
factors.
• I suggest comparing UST persistence rates of other second line use (PMID: 32441396,
36600684, 32249966) near the first line use in the Discussion.
• Please add limitations of the study.
• Please comment on the weakness of persistence outcome compared to other (harder) efficacy
outcomes (chronic mild activity, treatment supplementation).
• The label of Y axis of Figure 1,2,3 may be changed to probability of failure.
Title: Superior Persistence of Ustekinumab Compared to Anti-TNF in Vedolizumab-
Experienced Inflammatory Bowel Diseases Patients: A Real- world Cohort Study
Version: 1 Date: 27 Sep 2024
Reviewer's report:
Thank you for the invitation to review the manuscript by Horng-Yih Chiu et al entitled " Superior
Persistence of Ustekinumab Compared to Anti-TNF in Vedolizumab-Experienced Inflammatory
Bowel Diseases Patients: A Real-world Cohort Study”.
Horng-Yih Chiu et al performed a retrospective analysis on the persistence of UST vs anti-TNF
amongst IBD patients after VDZ failure. The topic is interesting. The paper is well-written, here
are some comments that suggested to be clarified in a revised version of the manuscript:
• Were other anti-TNF agents (golimumab, certolizumab) used?
• Please define catastrophic illness in Methods
• Was IFX dose escalation (to 10 mg pro kg) allowed?
• How was uni- and multivariable (multivariate?) models handled? Please specify model
selection.
• The high persistence rate of UST is interesting but needs explanation. Why was IFX dose
escalation rate lower than UST while the persistence was higher? Were these cases due to allergy
or PNR or something else? You state that the most frequent cause of failure was secondary loss
of response. Please comment.
• Is it available to use VDZ as first line in general in your center? If yes, please comment it, if no
please describe patient population in more details regarding comorbidities and other influencing
factors.
• I suggest comparing UST persistence rates of other second line use (PMID: 32441396,
36600684, 32249966) near the first line use in the Discussion.
• Please add limitations of the study.
• Please comment on the weakness of persistence outcome compared to other (harder) efficacy
outcomes (chronic mild activity, treatment supplementation).
• The label of Y axis of Figure 1,2,3 may be changed to probability of failure.
Please review this paper.
user
Title: Superior Persistence of Ustekinumab Compared to Anti-TNF in Vedolizumab-
Experienced Inflammatory Bowel Diseases Patients: A Real- world Cohort Study
Version: 1 Date: 27 Sep 2024
Reviewer's report:
Thank you for the invitation to review the manuscript by Horng-Yih Chiu et al entitled " Superior
Persistence of Ustekinumab Compared to Anti-TNF in Vedolizumab-Experienced Inflammatory
Bowel Diseases Patients: A Real-world Cohort Study”.
Horng-Yih Chiu et al performed a retrospective analysis on the persistence of UST vs anti-TNF
amongst IBD patients after VDZ failure. The topic is interesting. The paper is well-written, here
are some comments that suggested to be clarified in a revised version of the manuscript:
• Were other anti-TNF agents (golimumab, certolizumab) used?
• Please define catastrophic illness in Methods
• Was IFX dose escalation (to 10 mg pro kg) allowed?
• How was uni- and multivariable (multivariate?) models handled? Please specify model
selection.
• The high persistence rate of UST is interesting but needs explanation. Why was IFX dose
escalation rate lower than UST while the persistence was higher? Were these cases due to allergy
or PNR or something else? You state that the most frequent cause of failure was secondary loss
of response. Please comment.
• Is it available to use VDZ as first line in general in your center? If yes, please comment it, if no
please describe patient population in more details regarding comorbidities and other influencing
factors.
• I suggest comparing UST persistence rates of other second line use (PMID: 32441396,
36600684, 32249966) near the first line use in the Discussion.
• Please add limitations of the study.
• Please comment on the weakness of persistence outcome compared to other (harder) efficacy
outcomes (chronic mild activity, treatment supplementation).
• The label of Y axis of Figure 1,2,3 may be changed to probability of failure.
assistant