Title: EFFICACY OF USTEKINUMAB, VEDOLIZUMAB, OR A SECOND ANTI-TNF
AGENT AFTER THE FAILURE OF A FIRST ANTI-TNF AGENT IN PATIENTS WITH
CROHN’S DISEASE: A MULTICENTRE RETROSPECTIVE STUDY
Version: 4 Date: 08 Oct 2022
Reviewer:  Ilhami Yüksel
Reviewer's report:
The objective of this multicenter retrospective study was to assess the effectiveness of
ustekinumab, vedolizumab, and a second anti-TNF treatment in CD patients in whom a first
anti-TNF therapy had failed. And the authors demonstrated that VDZ, UST, and a second anti-
TNF agent in those individuals exhibit similar efficacy in the short run as second-biological line
treatment, while shorter drug maintenance is seen in patients treated with UST.
After the first anti-TNF medication in CD failed, the study that is being presented offers
useful information about direct comparisons of biologics. But I do have a few comments and
suggestions.
In the materials and methods; the authors described second anti-TNF agent as a control group that
had records extracted from a prospective database from a single centre cohort (Rennes, CNIL
No. 1412467). I believe that group is not a control group; instead, it may be a key comparison
group with VDZ and UST.
Table 1 should contain the baseline HBI level and p value (at the beginning of the second line
biologic).
The rate of the isolated upper gastrointestinal involvement seemed to be somewhat high.
Can the author explain the circumstances here? Or does it concomitant upper gastrointestinal
involvement? Those who had concurrent upper gastrointestinal involvement and CD patients
should be addressed by the authors if it is not.
Baseline unfavorable prognostic factors, such as penetrating behavior, that would affect
outcomes should be fully noted in the Table 1 and text. All relevant data should be debated in the
discussion if there are any statistical differences that suggest penetrating illness is less common
in the anti-TNF group than in other groups (required given the p value in Tablo1).
After editing and minor recommendation, this paper is suitable for publication.
Title: EFFICACY OF USTEKINUMAB, VEDOLIZUMAB, OR A SECOND ANTI-TNF
AGENT AFTER THE FAILURE OF A FIRST ANTI-TNF AGENT IN PATIENTS WITH
CROHN’S DISEASE: A MULTICENTRE RETROSPECTIVE STUDY
Version: 4 Date: 08 Oct 2022
Reviewer:  Ilhami Yüksel
Reviewer's report:
The objective of this multicenter retrospective study was to assess the effectiveness of
ustekinumab, vedolizumab, and a second anti-TNF treatment in CD patients in whom a first
anti-TNF therapy had failed. And the authors demonstrated that VDZ, UST, and a second anti-
TNF agent in those individuals exhibit similar efficacy in the short run as second-biological line
treatment, while shorter drug maintenance is seen in patients treated with UST.
After the first anti-TNF medication in CD failed, the study that is being presented offers
useful information about direct comparisons of biologics. But I do have a few comments and
suggestions.
In the materials and methods; the authors described second anti-TNF agent as a control group that
had records extracted from a prospective database from a single centre cohort (Rennes, CNIL
No. 1412467). I believe that group is not a control group; instead, it may be a key comparison
group with VDZ and UST.
Table 1 should contain the baseline HBI level and p value (at the beginning of the second line
biologic).
The rate of the isolated upper gastrointestinal involvement seemed to be somewhat high.
Can the author explain the circumstances here? Or does it concomitant upper gastrointestinal
involvement? Those who had concurrent upper gastrointestinal involvement and CD patients
should be addressed by the authors if it is not.
Baseline unfavorable prognostic factors, such as penetrating behavior, that would affect
outcomes should be fully noted in the Table 1 and text. All relevant data should be debated in the
discussion if there are any statistical differences that suggest penetrating illness is less common
in the anti-TNF group than in other groups (required given the p value in Tablo1).
After editing and minor recommendation, this paper is suitable for publication.
Please review this paper.
user
Title: EFFICACY OF USTEKINUMAB, VEDOLIZUMAB, OR A SECOND ANTI-TNF
AGENT AFTER THE FAILURE OF A FIRST ANTI-TNF AGENT IN PATIENTS WITH
CROHN’S DISEASE: A MULTICENTRE RETROSPECTIVE STUDY
Version: 4 Date: 08 Oct 2022
Reviewer:  Ilhami Yüksel
Reviewer's report:
The objective of this multicenter retrospective study was to assess the effectiveness of
ustekinumab, vedolizumab, and a second anti-TNF treatment in CD patients in whom a first
anti-TNF therapy had failed. And the authors demonstrated that VDZ, UST, and a second anti-
TNF agent in those individuals exhibit similar efficacy in the short run as second-biological line
treatment, while shorter drug maintenance is seen in patients treated with UST.
After the first anti-TNF medication in CD failed, the study that is being presented offers
useful information about direct comparisons of biologics. But I do have a few comments and
suggestions.
In the materials and methods; the authors described second anti-TNF agent as a control group that
had records extracted from a prospective database from a single centre cohort (Rennes, CNIL
No. 1412467). I believe that group is not a control group; instead, it may be a key comparison
group with VDZ and UST.
Table 1 should contain the baseline HBI level and p value (at the beginning of the second line
biologic).
The rate of the isolated upper gastrointestinal involvement seemed to be somewhat high.
Can the author explain the circumstances here? Or does it concomitant upper gastrointestinal
involvement? Those who had concurrent upper gastrointestinal involvement and CD patients
should be addressed by the authors if it is not.
Baseline unfavorable prognostic factors, such as penetrating behavior, that would affect
outcomes should be fully noted in the Table 1 and text. All relevant data should be debated in the
discussion if there are any statistical differences that suggest penetrating illness is less common
in the anti-TNF group than in other groups (required given the p value in Tablo1).
After editing and minor recommendation, this paper is suitable for publication.
assistant