PONE-D-21-30242Meta-analysis of efficacy and safety of sustained release oxycodone hydrochloride rectal administration for moderate to severe painPLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: No

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The article is worthwhile as it addresses important clinical issues of pain management. In my professional opinion this paper will benefit the current clinical practice, however, I feel significant issues need to be seriously addressed. One of my main concern is the definition of moderate to severe pain that is not included. As this is part of the title, author must clearly define the term as per defined in all selected papers included in the review.

Initial paragraph in the discussion is repetitive to the information and phrases included in the introduction. Please revise the paragraph and assure that the there is no overlapping between these sections. The utilisation of short form for 1h and 3h that represent 'hour' should be avoided and written in full.

The paper contains quite significant grammatical errors and sentences are not written in proper English, therefore, it is suggestible for the author to send the paper to be edited by professional native English editor. This is imperative as the paper contains information that is useful for reference in clinical practice.

Eg; 'On the one hand, it can avoid the influence of nausea and vomiting caused by the primary disease on drug absorption; on the other hand, after rectal administration, the drug does not pass through the liver, thereby avoiding the first pass effect of the liver and increasing the blood drug concentration; the drug does not pass through the stomach And the small intestine, avoid the influence and destruction of acid, alkali and digestive enzymes on the medicine, reduce the irritation of the medicine to the stomach and intestines, and greatly improve the bioavailability of the medicine.'

The information that is not properly written in professional English may impede future reference and citation, hence, affecting the quality of this paper. I believe if the paper can be improved to assure that it is publishable.

Reviewer #2: The authors has produce an excellent data for this study. It is a very good alternative way to administered the mentioned medicine especially for cancer patients with difficulty to swallow. This method also will reduce several unwanted effects.

The authors has thoroughly stated the methods. There are several minor formatting issues that need to be reviewed before being accepted.

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Reviewer #1: Yes: Norsham Juliana

Reviewer #2: No

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Meta-analysis of efficacy and safety of sustained release oxycodone hydrochloride rectal administration for moderate to severe pain

PONE-D-21-30242R1

Dear Dr. hou,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Girish Sailor

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The author has addressed all comments and the manuscript is ready for target audience. The article has been rewritten with proper grammar and easy to read.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Norsham Juliana