We thank Dr. Sentilhes and colleagues for their interest in our publication (1). We agree that the statistical and clinical heterogeneity within the studies is high. However a random effect model was used to pooled data. Under this model we allow that the true effect could vary from study to study. Therefore, even if there is a significant heterogeneity between the studies, the weights assigned under random effects are balanced. Regarding the quality of the studies, most of the included trials are judged to be low risk of bias in selection bias and were double-blind. This article is protected by copyright. All rights reserved.