Reviewer's report
Title:The role of ursodeoxycholic acid in nonalcoholic steatohepatitis-a
systematic review
Version: 1Date:3 February 2013
Reviewer: Raluca Pais
Reviewer's report:
The present systematic review analyzed the impact of UDCA as derived from
randomized control trials on liver biology and histology in patients with NAFLD.
Major comments:
1. No critical interpretation of the results of included studies is provided. As you
mentioned, there is an important heterogeneity of the different trials and there are
discrepancies in the reported outcomes. However, when looking attentively to the
design, inclusion criteria and primary outcomes (in placebo and treatment arms)
of these studies, these discrepancies may be easily explained. For example, in
Leuschner’s study, transaminases levels decreased with a similar magnitude in
placebo and in UDCA group, which might explain the lack of statistical
significance when the two groups were compared. Also provide comments on the
inclusion criteria regarding elevated transaminases levels used in the two
studies.
2. Footnote table 3- fibrosis at follow-up in Ratziu’s study was assessed by
FibroTest not by Fibroscan
3. Please comment on the effect of UDCA on metabolic parameters (when this
end point was assessed).
4. Please focus the discussion section of the methodological design of the main
UDCA trials.
Because the lack of a critical analysis of the outcomes reported by the different
trials, I consider that the message derived from this systematic review is not
pertinent enough to be published in its actual from unless major revisions.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:The role of ursodeoxycholic acid in nonalcoholic steatohepatitis-a
systematic review
Version: 1Date:3 February 2013
Reviewer: Raluca Pais
Reviewer's report:
The present systematic review analyzed the impact of UDCA as derived from
randomized control trials on liver biology and histology in patients with NAFLD.
Major comments:
1. No critical interpretation of the results of included studies is provided. As you
mentioned, there is an important heterogeneity of the different trials and there are
discrepancies in the reported outcomes. However, when looking attentively to the
design, inclusion criteria and primary outcomes (in placebo and treatment arms)
of these studies, these discrepancies may be easily explained. For example, in
Leuschner’s study, transaminases levels decreased with a similar magnitude in
placebo and in UDCA group, which might explain the lack of statistical
significance when the two groups were compared. Also provide comments on the
inclusion criteria regarding elevated transaminases levels used in the two
studies.
2. Footnote table 3- fibrosis at follow-up in Ratziu’s study was assessed by
FibroTest not by Fibroscan
3. Please comment on the effect of UDCA on metabolic parameters (when this
end point was assessed).
4. Please focus the discussion section of the methodological design of the main
UDCA trials.
Because the lack of a critical analysis of the outcomes reported by the different
trials, I consider that the message derived from this systematic review is not
pertinent enough to be published in its actual from unless major revisions.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:The role of ursodeoxycholic acid in nonalcoholic steatohepatitis-a
systematic review
Version: 1Date:3 February 2013
Reviewer: Raluca Pais
Reviewer's report:
The present systematic review analyzed the impact of UDCA as derived from
randomized control trials on liver biology and histology in patients with NAFLD.
Major comments:
1. No critical interpretation of the results of included studies is provided. As you
mentioned, there is an important heterogeneity of the different trials and there are
discrepancies in the reported outcomes. However, when looking attentively to the
design, inclusion criteria and primary outcomes (in placebo and treatment arms)
of these studies, these discrepancies may be easily explained. For example, in
Leuschner’s study, transaminases levels decreased with a similar magnitude in
placebo and in UDCA group, which might explain the lack of statistical
significance when the two groups were compared. Also provide comments on the
inclusion criteria regarding elevated transaminases levels used in the two
studies.
2. Footnote table 3- fibrosis at follow-up in Ratziu’s study was assessed by
FibroTest not by Fibroscan
3. Please comment on the effect of UDCA on metabolic parameters (when this
end point was assessed).
4. Please focus the discussion section of the methodological design of the main
UDCA trials.
Because the lack of a critical analysis of the outcomes reported by the different
trials, I consider that the message derived from this systematic review is not
pertinent enough to be published in its actual from unless major revisions.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
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