Reviewer ’s report  
 
Title: Comparison of sequential therapy with standard triple therapy for Helicobacter pylori  
eradication in inactive peptic ulcer disease, and the efficiency of sequential therapy in inactive  
peptic ulcer disease and non -ulcer dyspepsia  
 
Version: 0 Date: 07 Oct 2015  
 
Reviewer: Ming -Jen Chen  
 
Reviewer ’s report:  
 
Sequential therapy achieves a superior result for  H. pylori eradication in peptic ulcer disease in 
some circumference. However, no study has yet compared the efficacy of sequential therapy for 
H. pylori eradication exclusively on inactive duodenal ulcer (iDU). The aim of this study is to 
evaluate the eff icacy of sequential therapy for H. pylori eradication in patients with iDU or 
NUD. Although this article is well -written and quite interesting, there are some concerns on the 
methodology whic h need to be further clarified.  
 
 
Comments to the authors:  
 
1. The aim of this study was to compare the efficacy of sequential therapy with standard 
triple therapy in patients with iDU or NUD. In the method session, patients with iDU 
were assigned into triple therapy group or sequential therapy. However, all patients wit h 
NUD were only treated with sequential therapy. The author cannot compare of 10 -day 
sequential therapy with 7 -day standard triple therapy for Helicobacter pylori eradication 
in non -ulcer dyspepsia. The title will lead reader confuse.  
 
2. Your title is "Co mparison of 10 -day sequential therapy with 7 -day standard triple therapy 
for Helicobacter pylori eradication in inactive peptic ulcer disease and non -ulcer 
dyspepsia" and authors draw a conclusion of "A successful eradication difference existed 
between pat ients with iDU and NUD for the sequential regimen." The author should well 
clarify their primary or secondary outcomes in the method session and set a relevant title 
of the study.  
 
3. The authors should not overwhelm a "better" outcome when the difference i s not 
statistically significant. For example: "Subgroup analysis revealed that the eradication 
rate of sequential therapy is "better" than triple therapy in duodenal ulcer scar patients 
(Table 2; ITT, 87.3% vs. 77.3%; PP, 92.4% vs. 85.0%)." However, "The d ifference was 
not statistically significant."  
 
4. "Overall, the eradication rate of sequential therapy was 88.1% with PP analysis and 
83.5% with ITT analysis, which were higher than those of triple therapy (85.0% with PP 
analysis and 77.3% with ITT analysis ). Is this result from your study? If not, please site 
the reference.  
5. The authors suggest the reason why their results did not yield a higher eradication 
efficacy may be due to the patient pool only consisted of either inactive duodenal ulcer or 
non-ulcer dyspepsia patients. The suggestion is lack of evidence of causal connection. 
What is your hypothesis for an eradication difference existed between patients with iDU 
and non -ulcer dyspepsia? Why you do not enroll the patient with inactive gastric ulcer?  
 
6. Most importantly, is it clinical relevant to treat HP with the consideration of the inactive 
peptic ulcers, active ulcer diseases or non -ulcer dyspepsia? What is you point?  
 
Are the methods appropriate and well de scribed?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is re commended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation  that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, e ither now or in the future?  
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relatin g to the content of the manuscript?  
 
5.  Do you have any other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing i nterests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the  manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will no t be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Comparison of sequential therapy with standard triple therapy for Helicobacter pylori  
eradication in inactive peptic ulcer disease, and the efficiency of sequential therapy in inactive  
peptic ulcer disease and non -ulcer dyspepsia  
 
Version: 0 Date: 07 Oct 2015  
 
Reviewer: Ming -Jen Chen  
 
Reviewer ’s report:  
 
Sequential therapy achieves a superior result for  H. pylori eradication in peptic ulcer disease in 
some circumference. However, no study has yet compared the efficacy of sequential therapy for 
H. pylori eradication exclusively on inactive duodenal ulcer (iDU). The aim of this study is to 
evaluate the eff icacy of sequential therapy for H. pylori eradication in patients with iDU or 
NUD. Although this article is well -written and quite interesting, there are some concerns on the 
methodology whic h need to be further clarified.  
 
 
Comments to the authors:  
 
1. The aim of this study was to compare the efficacy of sequential therapy with standard 
triple therapy in patients with iDU or NUD. In the method session, patients with iDU 
were assigned into triple therapy group or sequential therapy. However, all patients wit h 
NUD were only treated with sequential therapy. The author cannot compare of 10 -day 
sequential therapy with 7 -day standard triple therapy for Helicobacter pylori eradication 
in non -ulcer dyspepsia. The title will lead reader confuse.  
 
2. Your title is "Co mparison of 10 -day sequential therapy with 7 -day standard triple therapy 
for Helicobacter pylori eradication in inactive peptic ulcer disease and non -ulcer 
dyspepsia" and authors draw a conclusion of "A successful eradication difference existed 
between pat ients with iDU and NUD for the sequential regimen." The author should well 
clarify their primary or secondary outcomes in the method session and set a relevant title 
of the study.  
 
3. The authors should not overwhelm a "better" outcome when the difference i s not 
statistically significant. For example: "Subgroup analysis revealed that the eradication 
rate of sequential therapy is "better" than triple therapy in duodenal ulcer scar patients 
(Table 2; ITT, 87.3% vs. 77.3%; PP, 92.4% vs. 85.0%)." However, "The d ifference was 
not statistically significant."  
 
4. "Overall, the eradication rate of sequential therapy was 88.1% with PP analysis and 
83.5% with ITT analysis, which were higher than those of triple therapy (85.0% with PP 
analysis and 77.3% with ITT analysis ). Is this result from your study? If not, please site 
the reference.  
5. The authors suggest the reason why their results did not yield a higher eradication 
efficacy may be due to the patient pool only consisted of either inactive duodenal ulcer or 
non-ulcer dyspepsia patients. The suggestion is lack of evidence of causal connection. 
What is your hypothesis for an eradication difference existed between patients with iDU 
and non -ulcer dyspepsia? Why you do not enroll the patient with inactive gastric ulcer?  
 
6. Most importantly, is it clinical relevant to treat HP with the consideration of the inactive 
peptic ulcers, active ulcer diseases or non -ulcer dyspepsia? What is you point?  
 
Are the methods appropriate and well de scribed?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is re commended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation  that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, e ither now or in the future?  
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relatin g to the content of the manuscript?  
 
5.  Do you have any other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing i nterests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the  manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will no t be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Comparison of sequential therapy with standard triple therapy for Helicobacter pylori  
eradication in inactive peptic ulcer disease, and the efficiency of sequential therapy in inactive  
peptic ulcer disease and non -ulcer dyspepsia  
 
Version: 0 Date: 07 Oct 2015  
 
Reviewer: Ming -Jen Chen  
 
Reviewer ’s report:  
 
Sequential therapy achieves a superior result for  H. pylori eradication in peptic ulcer disease in 
some circumference. However, no study has yet compared the efficacy of sequential therapy for 
H. pylori eradication exclusively on inactive duodenal ulcer (iDU). The aim of this study is to 
evaluate the eff icacy of sequential therapy for H. pylori eradication in patients with iDU or 
NUD. Although this article is well -written and quite interesting, there are some concerns on the 
methodology whic h need to be further clarified.  
 
 
Comments to the authors:  
 
1. The aim of this study was to compare the efficacy of sequential therapy with standard 
triple therapy in patients with iDU or NUD. In the method session, patients with iDU 
were assigned into triple therapy group or sequential therapy. However, all patients wit h 
NUD were only treated with sequential therapy. The author cannot compare of 10 -day 
sequential therapy with 7 -day standard triple therapy for Helicobacter pylori eradication 
in non -ulcer dyspepsia. The title will lead reader confuse.  
 
2. Your title is "Co mparison of 10 -day sequential therapy with 7 -day standard triple therapy 
for Helicobacter pylori eradication in inactive peptic ulcer disease and non -ulcer 
dyspepsia" and authors draw a conclusion of "A successful eradication difference existed 
between pat ients with iDU and NUD for the sequential regimen." The author should well 
clarify their primary or secondary outcomes in the method session and set a relevant title 
of the study.  
 
3. The authors should not overwhelm a "better" outcome when the difference i s not 
statistically significant. For example: "Subgroup analysis revealed that the eradication 
rate of sequential therapy is "better" than triple therapy in duodenal ulcer scar patients 
(Table 2; ITT, 87.3% vs. 77.3%; PP, 92.4% vs. 85.0%)." However, "The d ifference was 
not statistically significant."  
 
4. "Overall, the eradication rate of sequential therapy was 88.1% with PP analysis and 
83.5% with ITT analysis, which were higher than those of triple therapy (85.0% with PP 
analysis and 77.3% with ITT analysis ). Is this result from your study? If not, please site 
the reference.  
5. The authors suggest the reason why their results did not yield a higher eradication 
efficacy may be due to the patient pool only consisted of either inactive duodenal ulcer or 
non-ulcer dyspepsia patients. The suggestion is lack of evidence of causal connection. 
What is your hypothesis for an eradication difference existed between patients with iDU 
and non -ulcer dyspepsia? Why you do not enroll the patient with inactive gastric ulcer?  
 
6. Most importantly, is it clinical relevant to treat HP with the consideration of the inactive 
peptic ulcers, active ulcer diseases or non -ulcer dyspepsia? What is you point?  
 
Are the methods appropriate and well de scribed?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is re commended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation  that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, e ither now or in the future?  
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relatin g to the content of the manuscript?  
 
5.  Do you have any other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing i nterests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the  manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will no t be published.  
 
I agree to the open peer review policy of the journal  
assistant