Reviewer's report
Title:Treatment with Pirfenidone for two years decreases fibrosis, cytokine levels
and enhances CB2 expression in patients with chronic hepatitis C: open-label
clinical trial
Version:2Date:6 January 2014
Reviewer: lawrence serfaty
Reviewer's report:
Contreras et al have investigated the efficacy of Pirfenidone in the treatment of
chronic hepatitis C. This molecule used in the treatment of pulmonary fibrosis
was given for 2 years in 34 HCV patients with different stage of disease severity.
Control liver biopsy showed a significant improvement of steatosis, fibrosis and
inflammation. Some cirrhotic patients improved their Child score. Molecular
analysis showed modulation of CB receptors expression.
Authors published similar results in a previous small pilot study (Gut 2006).
Accordingly, I don't understand why they did not perform a randomized controlled
study rather than a second pilot study.
Moreover, in the era of DAAs, the relevance of this antifibrotic treatment is likely
out of relevance. I have also major concerns with the safety of this molecule.
Results should be presented in intend to treat (6 patients excluded of the efficacy
analysis)
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I have no competing interest with this paper.
Reviewer's report
Title:Treatment with Pirfenidone for two years decreases fibrosis, cytokine levels
and enhances CB2 expression in patients with chronic hepatitis C: open-label
clinical trial
Version:2Date:6 January 2014
Reviewer: lawrence serfaty
Reviewer's report:
Contreras et al have investigated the efficacy of Pirfenidone in the treatment of
chronic hepatitis C. This molecule used in the treatment of pulmonary fibrosis
was given for 2 years in 34 HCV patients with different stage of disease severity.
Control liver biopsy showed a significant improvement of steatosis, fibrosis and
inflammation. Some cirrhotic patients improved their Child score. Molecular
analysis showed modulation of CB receptors expression.
Authors published similar results in a previous small pilot study (Gut 2006).
Accordingly, I don't understand why they did not perform a randomized controlled
study rather than a second pilot study.
Moreover, in the era of DAAs, the relevance of this antifibrotic treatment is likely
out of relevance. I have also major concerns with the safety of this molecule.
Results should be presented in intend to treat (6 patients excluded of the efficacy
analysis)
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I have no competing interest with this paper.
Please review this paper.
user
Reviewer's report
Title:Treatment with Pirfenidone for two years decreases fibrosis, cytokine levels
and enhances CB2 expression in patients with chronic hepatitis C: open-label
clinical trial
Version:2Date:6 January 2014
Reviewer: lawrence serfaty
Reviewer's report:
Contreras et al have investigated the efficacy of Pirfenidone in the treatment of
chronic hepatitis C. This molecule used in the treatment of pulmonary fibrosis
was given for 2 years in 34 HCV patients with different stage of disease severity.
Control liver biopsy showed a significant improvement of steatosis, fibrosis and
inflammation. Some cirrhotic patients improved their Child score. Molecular
analysis showed modulation of CB receptors expression.
Authors published similar results in a previous small pilot study (Gut 2006).
Accordingly, I don't understand why they did not perform a randomized controlled
study rather than a second pilot study.
Moreover, in the era of DAAs, the relevance of this antifibrotic treatment is likely
out of relevance. I have also major concerns with the safety of this molecule.
Results should be presented in intend to treat (6 patients excluded of the efficacy
analysis)
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I have no competing interest with this paper.
assistant