Reviewer’s report
Title:  Vedolizumab  use  after  failure  of  TNF- α  antagonists  in  children  and  adolescents  with
inflammatory bowel disease
Version: 0 Date: 07 Jun 2018
Reviewer: Amit Assa
Reviewer's report:
In general, there are only few reports on tretment with vedolizumab in pediatric patients. Nevertheless,
there is sufficient retrospective data from larger cohorts so this paper does not add significant data to
the existing data.
Major comments:
1. Only few patients from each disease type reported.
2. Were there patients treated with 2 or more biologic agents prior to vedo?
3. There is no such thing as partial remission. Should be changed to partial response.
4. Fecal calprotectin data would be beneficial.
5. Knowledge of the type of loss of response to anti TNF is crucial in order to understand the
mechanism of vedo response (immunogenic, pharmacokinetic, pharmacodynamic) so anti-TNF
levels at the time of TNF failure should be reported.
Are the methods appropriate and well described?
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.
Unable to assess
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you recommend an additional 
statistical review?
If an additional statistical review is recommended, 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, either 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 relating 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 interests' below. If 
your reply is yes to any, please give details below.
None
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 not
be published.
I agree to the open peer review policy of the journal
Reviewer’s report
Title:  Vedolizumab  use  after  failure  of  TNF- α  antagonists  in  children  and  adolescents  with
inflammatory bowel disease
Version: 0 Date: 07 Jun 2018
Reviewer: Amit Assa
Reviewer's report:
In general, there are only few reports on tretment with vedolizumab in pediatric patients. Nevertheless,
there is sufficient retrospective data from larger cohorts so this paper does not add significant data to
the existing data.
Major comments:
1. Only few patients from each disease type reported.
2. Were there patients treated with 2 or more biologic agents prior to vedo?
3. There is no such thing as partial remission. Should be changed to partial response.
4. Fecal calprotectin data would be beneficial.
5. Knowledge of the type of loss of response to anti TNF is crucial in order to understand the
mechanism of vedo response (immunogenic, pharmacokinetic, pharmacodynamic) so anti-TNF
levels at the time of TNF failure should be reported.
Are the methods appropriate and well described?
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.
Unable to assess
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you recommend an additional 
statistical review?
If an additional statistical review is recommended, 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, either 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 relating 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 interests' below. If 
your reply is yes to any, please give details below.
None
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 not
be published.
I agree to the open peer review policy of the journal
Please review this paper.
user
Reviewer’s report
Title:  Vedolizumab  use  after  failure  of  TNF- α  antagonists  in  children  and  adolescents  with
inflammatory bowel disease
Version: 0 Date: 07 Jun 2018
Reviewer: Amit Assa
Reviewer's report:
In general, there are only few reports on tretment with vedolizumab in pediatric patients. Nevertheless,
there is sufficient retrospective data from larger cohorts so this paper does not add significant data to
the existing data.
Major comments:
1. Only few patients from each disease type reported.
2. Were there patients treated with 2 or more biologic agents prior to vedo?
3. There is no such thing as partial remission. Should be changed to partial response.
4. Fecal calprotectin data would be beneficial.
5. Knowledge of the type of loss of response to anti TNF is crucial in order to understand the
mechanism of vedo response (immunogenic, pharmacokinetic, pharmacodynamic) so anti-TNF
levels at the time of TNF failure should be reported.
Are the methods appropriate and well described?
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.
Unable to assess
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you recommend an additional 
statistical review?
If an additional statistical review is recommended, 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, either 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 relating 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 interests' below. If 
your reply is yes to any, please give details below.
None
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 not
be published.
I agree to the open peer review policy of the journal
assistant