Title: The insoluble excretion of multi-matrix system mesalazine preparations in patients with
ulcerative colitis
Version: 3 Date: 21 May 2022
Reviewer's report:
Review Comment
In the manuscript by Ohtaki et al., the authors attempt to examine clinical features related to the
insoluble excretion of multi-matrix system mesalazine (MMX) in patients with ulcerative colitis
(UC). They concluded that defecation frequency and the extent of inflammation could affect the
insoluble excretion of MMX. While this reviewer agrees that the insoluble excretion of MMX
needs to be considered in patients with UC, there are several concerns for this manuscript.
(1) The authors performed the ROC analysis using the defecation frequency at the start of
treatment (DF) for predicting the insoluble excretion of MMX. Since the AUC is 0.687, this
result suggests that DF is not useful for predicting the insoluble excretion of MMX. This
reviewer does not believe this result supports the authors’ conclusion.
(2) The authors performed the multivariate logistic regression analysis employing 3 factors (i.e.,
disease type, stool consistency, and defecation frequency at the start of treatment). However,
given that 15 out of 102 patients experienced the insoluble excretion of MMX in this study,
the multivariate analysis employing 3 factors is not appropriate. The authors are advised to
reconsider the sample size and statistical analyses.
(3) The study design and the patient characteristics need to be described in more detail. Below
are just some examples.
(i) When the colonoscopy and/or other examinations to determine the disease type were
performed?
(ii) The UC disease activity of patients needs to be shown.
(iii) When the excretion of insoluble MMX was examined (e.g., during the first week after
starting treatment)?
(4) The authors need to describe if there were any differences in the clinical efficacy of MMX
between patients who experienced the excretion of insoluble MMX vs. those who did not.
Title: The insoluble excretion of multi-matrix system mesalazine preparations in patients with
ulcerative colitis
Version: 3 Date: 21 May 2022
Reviewer's report:
Review Comment
In the manuscript by Ohtaki et al., the authors attempt to examine clinical features related to the
insoluble excretion of multi-matrix system mesalazine (MMX) in patients with ulcerative colitis
(UC). They concluded that defecation frequency and the extent of inflammation could affect the
insoluble excretion of MMX. While this reviewer agrees that the insoluble excretion of MMX
needs to be considered in patients with UC, there are several concerns for this manuscript.
(1) The authors performed the ROC analysis using the defecation frequency at the start of
treatment (DF) for predicting the insoluble excretion of MMX. Since the AUC is 0.687, this
result suggests that DF is not useful for predicting the insoluble excretion of MMX. This
reviewer does not believe this result supports the authors’ conclusion.
(2) The authors performed the multivariate logistic regression analysis employing 3 factors (i.e.,
disease type, stool consistency, and defecation frequency at the start of treatment). However,
given that 15 out of 102 patients experienced the insoluble excretion of MMX in this study,
the multivariate analysis employing 3 factors is not appropriate. The authors are advised to
reconsider the sample size and statistical analyses.
(3) The study design and the patient characteristics need to be described in more detail. Below
are just some examples.
(i) When the colonoscopy and/or other examinations to determine the disease type were
performed?
(ii) The UC disease activity of patients needs to be shown.
(iii) When the excretion of insoluble MMX was examined (e.g., during the first week after
starting treatment)?
(4) The authors need to describe if there were any differences in the clinical efficacy of MMX
between patients who experienced the excretion of insoluble MMX vs. those who did not.
Please review this paper.
user
Title: The insoluble excretion of multi-matrix system mesalazine preparations in patients with
ulcerative colitis
Version: 3 Date: 21 May 2022
Reviewer's report:
Review Comment
In the manuscript by Ohtaki et al., the authors attempt to examine clinical features related to the
insoluble excretion of multi-matrix system mesalazine (MMX) in patients with ulcerative colitis
(UC). They concluded that defecation frequency and the extent of inflammation could affect the
insoluble excretion of MMX. While this reviewer agrees that the insoluble excretion of MMX
needs to be considered in patients with UC, there are several concerns for this manuscript.
(1) The authors performed the ROC analysis using the defecation frequency at the start of
treatment (DF) for predicting the insoluble excretion of MMX. Since the AUC is 0.687, this
result suggests that DF is not useful for predicting the insoluble excretion of MMX. This
reviewer does not believe this result supports the authors’ conclusion.
(2) The authors performed the multivariate logistic regression analysis employing 3 factors (i.e.,
disease type, stool consistency, and defecation frequency at the start of treatment). However,
given that 15 out of 102 patients experienced the insoluble excretion of MMX in this study,
the multivariate analysis employing 3 factors is not appropriate. The authors are advised to
reconsider the sample size and statistical analyses.
(3) The study design and the patient characteristics need to be described in more detail. Below
are just some examples.
(i) When the colonoscopy and/or other examinations to determine the disease type were
performed?
(ii) The UC disease activity of patients needs to be shown.
(iii) When the excretion of insoluble MMX was examined (e.g., during the first week after
starting treatment)?
(4) The authors need to describe if there were any differences in the clinical efficacy of MMX
between patients who experienced the excretion of insoluble MMX vs. those who did not.
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