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Volume 13
Issue 2
10.3390/life13020369
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Systematic Review
Peer-Review Record

Citicoline for the Management of Patients with Traumatic Brain Injury in the Acute Phase: A Systematic Review and Meta-Analysis

Life 2023, 13(2), 369; https://doi.org/10.3390/life13020369
by Julio José Secades 1,*, Helmut Trimmel 2,3, Byron Salazar 4 and José Antonio González 5
Reviewer 1: Anonymous
Reviewer 2:
Amit Agrawal
Reviewer 3: Anonymous
Reviewer 4:
Marsha Pierce
Life 2023, 13(2), 369; https://doi.org/10.3390/life13020369
Submission received: 23 November 2022 / Revised: 18 January 2023 / Accepted: 26 January 2023 / Published: 29 January 2023
(This article belongs to the Section Physiology and Pathology)

Round 1

Reviewer 1 Report

The authors assessed the benefits and hazards of therapy with citicoline in patients with TBI through a systematic review and meta-analysis of comparative trials.

The paper is generally well written.

The design and interpretation of the results are proper within the scope of the data. 

Author Response

Thanks for your comments

Reviewer 2 Report

Dear Author,

This is an interesting effort.

The major limitation is with the studies included as these are too old and it can be easily extrapolated that management of the TBI patients is vastly changed.

Also, the included studies have mix of severe, moderate and mild injuries it will make the sample quite heterogenous and thus the Comparision and prediction of the outcomes difficult

Also, there is no new conclusion form the presented findings

 

 

 

Author Response

Thanks for your comments. We agree the major limitation is the gap between studies and for that reason we decided to perform the random effects analysis. We choose to include all the studies independently of the time to avoid a possible selection bias. We would like to focus only on moderate and severe TBI but we only have the paper of the COBRIT trial that includes mild-complicated injuries and the GOSe data were not subclassified in base on severity

The present findings only wants to show that there is some effect of the drug in the management of TBI as the drug is commercialized in several countries.

Reviewer 3 Report

The authors in this systematic review and meta-analysis of comparative trials aimed to describe the benefits of citicoline in patients with TBI. This paper is well written and presentation is very good.

Author Response

Thanks for your comments

Reviewer 4 Report


Comments for author File: Comments.pdf

Author Response

Please see attached document

Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

Still there are not many articles to support the evidence.

 

It will be better to modify as scoping or narrative review.

Author Response

Thanks for your comments

This study could be considered as complementary to a previous narrative review published recently (Pharmaceuticals (Basel). 2021 Apr 26;14(5):410. doi: 10.3390/ph14050410)

We agree to the limitations of the study, but we inluded all the information provided and with 2771 patients analyzed the information could be of some interest, as the drug is still used in the management of TBI in countries such Austria 

Thus, we consider the results of some interest for the clinical practice

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