Review History


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Summary

  • The initial submission of this article was received on May 18th, 2023 and was peer-reviewed by 3 reviewers and the Academic Editor.
  • The Academic Editor made their initial decision on August 22nd, 2023.
  • The first revision was submitted on September 29th, 2023 and was reviewed by 1 reviewer and the Academic Editor.
  • The article was Accepted by the Academic Editor on October 17th, 2023.

Version 0.2 (accepted)

· Oct 17, 2023 · Academic Editor

Accept

I have carefully reviewed the revised manuscript and am pleased to confirm that the authors have diligently addressed all of the reviewers' comments. I have assessed the changes made to the manuscript, and I am content with the current version. The manuscript now demonstrates a clear and comprehensive response to the earlier feedback, and it appears to be in a state ready for publication. Thank you for your hard work and dedication in improving the quality of the manuscript.

Reviewer 3 ·

Basic reporting

No comment

Experimental design

No comment

Validity of the findings

No comment

Version 0.1 (original submission)

· Aug 22, 2023 · Academic Editor

Major Revisions

Dear Authors,

I hope this message finds you well. We want to convey our sincere appreciation for your submission of the paper titled "The Effect of Polypharmacy on Rheumatoid and Psoriatic Arthritis Treatment" to our esteemed journal. We recognize the time and effort you invested in preparing this manuscript, and we value your contribution to our scholarly community.

We are pleased to inform you that the review process for your submission has been completed, and we have received feedback from the reviewers assigned to evaluate your paper. It is heartening to note that two out of the three reviewers have recognized the potential of your work to make a significant contribution to the field. They have provided valuable insights and recommendations aimed at further enhancing the manuscript. While these reviewers believe that your paper is deserving of publication, they have raised some major concerns that must be addressed to ensure its suitability for publication in our journal.

Furthermore, one of the reviewers has expressed concerns regarding the cover letter submitted by the authors, particularly concerning the mention of the same manuscript being submitted to another journal. We kindly request that you provide clarification on this matter.

In light of the reviewers' feedback, we kindly request that you address each concern in a point-by-point manner. Your response should be clear and concise, with the aim of facilitating the reviewers' understanding of the steps you intend to take to address their feedback and improve the manuscript.

Your commitment to addressing these concerns is crucial in the peer-review process and will help ensure the quality and suitability of your paper for publication in our journal. We appreciate your cooperation in this matter.

**PeerJ Staff Note:** Please ensure that all review, editorial, and staff comments are addressed in a response letter and any edits or clarifications mentioned in the letter are also inserted into the revised manuscript where appropriate.

**Language Note:** PeerJ staff have identified that the English language needs to be improved. When you prepare your next revision, please either (i) have a colleague who is proficient in English and familiar with the subject matter review your manuscript, or (ii) contact a professional editing service to review your manuscript. PeerJ can provide language editing services - you can contact us at copyediting@peerj.com for pricing (be sure to provide your manuscript number and title). – PeerJ Staff

Reviewer 1 ·

Basic reporting

.

Experimental design

.

Validity of the findings

.

Additional comments

Ozdemir who is corresponding author says ''I am submitting this original article to consideration for publication in Journal of Clinical Rheumatology'' in the cover letter. But this journal's name is “PeerJ”.

Reviewer 2 ·

Basic reporting

-Please revise the abstract, correct typos etc. e.g. "This study included PsA patients with only peripheral joint involvement and and RA patients". Please also provide the study design in the abstract.
-Substantial language editing is required. e.g. "While the mean ages of the RA
and PsA patients who had polypharmacy treatment at the beginning,..."
-"2010 Rheumatoid Arthritis Classification Criteria by American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) and those who were accepted as PsA according to the classification criteria by Classification of Psoriatic Arthritis (CASPAR). " Referencing s necessary.

Experimental design

-Patients had diverse treatment regimens which might have affected the results.
-"Charlson's Comorbidity Index (CCI) score" The Modified or the original one?
-"excluding over-the-counter" Why did you exclude such medications?
"Chi-square and Fisher's exact tests were" Which chi-squared test? The Pearson's?
-"A multiple logistic regression analysis with the backward method was used to determine the factors (dependent variable) associated with polypharmacy. " Waht is the dependent factor?

Validity of the findings

-How was the smaple size arrived at?

Additional comments

-All software used should be given along with manufacturer etc.
-"Although there are few studies on the effect of polypharmacy on treatment in RA patients; to the best of our knowledge this is the first study to show that polypharmacy affects treatment response in PsA patients. " Please refrain from stating novelty as a strength.

Reviewer 3 ·

Basic reporting

English revision is recommended. Below are some points that need attention to improve the overall quality and readability of this manuscript.

Abstract
The following sentence is not clear (lines 52-53): „While the mean ages of the RA and PsA patients who had polypharmacy treatment at the beginning, their ages were significantly higher than the ages of those who did not receive.
Correct the spelling in line 43
Correct abbreviation PSA in line 54 to be consistent

Introduction
In the introduction section the authors state that: „Apart from the comorbidities by aging, cardiovascular and metabolic comorbidities have increased due to diverse drugs in the treatment of diseases (Dougados, 2016)“. Is this reference appropriate, especially for cardiovascular disease? Also, medications used to treat RA, such as methotrexate, could be associated with significant reduction in cardiovascular adverse events. Thus, this issue needs to be better explained.

The following sentence should be modified (lines 72-73): Additional treatments are given to reduce side effects and morbidity depending on the treatment therapeutic advances in musculoskeletal disease.
In line 94 change „As age“ to „With aging“

Results
Correct spelling in line 176

Discussion
The following sentence should be modified (lines 242-243): In rheumatology, studies on polypharmacy are mostly conducted on old aged people, side effects and comorbidities.
Line 299-300 have Turkish language sentence… please remove this sentence from the text
Lines 285 and 310…correct the spelling
Line 324 reference is indicated by the number

Experimental design

In Material and methods section should be added what is accepted in this study under the term "polypharmacy".

Validity of the findings

In the manuscript entitled „The effect of polypharmacy on rheumatoid and psoriatic arthritis treatment“, the authors conducted a retrospective study that included a total of 232 patients with rheumatoid arthritis (RA) and 73 patients with psoriatic arthritis (PsA) but with peripheral joint involvement only. The objective of this retrospective study was to investigate 1) the prevalence of polypharmacy (defined as the concurrent use of five or more prescribed medications) and 2) the impact of polypharmacy on disease activity in RA and PsA.
The authors found that the presence of polypharmacy at baseline in both, RA and PsA patients was associated with a higher DAS-28 CRP score at the 6th month of treatment than in these patients without polypharmacy at baseline. However, the presence of polypharmacy at baseline was also associated with a higher DAS-28 CRP score at the 12th month of treatment in RA patients, but this was not the case in PsA patients i.e., after 12 months of treatment there is no significant difference in treatment efficacy (according to DAS-28 CRP score change) in patients with and without polypharmacy at baseline. It would be useful to clarify whether this effect of polypharmacy at baseline on PsA treatment decreases with the duration of treatment or whether this result is a consequence of the small sample size.
Also, is it possible that the higher DAS-28 CRP score at the 6th and 12th month of treatment in RA patients with baseline polypharmacy is associated with higher presence of comorbidity than in RA patients without baseline polypharmacy, as shown in Table 1?

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