Effect of Stem Cell Injections on Osteoarthritis-related Structural Outcomes: A Systematic Review
| Autor: | Louisa Chou, Flavia M. Cicuttini, Yuanyuan Wang, Anita E. Wluka, Sultana Monira Hussain, Jessica Fairley, Jennifer Gong, Rakhi Vashishtha |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Cartilage
Articular 0301 basic medicine Oncology medicine.medical_specialty Immunology Osteoarthritis Mesenchymal Stem Cell Transplantation Injections Intra-Articular law.invention 03 medical and health sciences 0302 clinical medicine Rheumatology Randomized controlled trial law Internal medicine medicine Humans Immunology and Allergy 030203 arthritis & rheumatology medicine.diagnostic_test business.industry Cartilage Arthroscopy Mesenchymal Stem Cells Publication bias Osteoarthritis Knee medicine.disease Clinical trial 030104 developmental biology medicine.anatomical_structure Bone marrow business |
| Zdroj: | The Journal of Rheumatology. 48:585-597 |
| ISSN: | 1499-2752 0315-162X |
| Popis: | ObjectiveTo systematically review the evidence for the efficacy of mesenchymal stem cell (MSC) injections in improving osteoarthritis (OA)-related structural outcomes.MethodsOvid Medline and EMBASE were searched from their inceptions to April 2020 using MeSH terms and key words. Independent reviewers extracted data and assessed methodological quality. Qualitative evidence synthesis was performed due to the heterogeneity of interventions and outcome measures.ResultsThirteen randomized controlled trials (phase I or II) were identified: 10 in OA populations and 3 in populations at risk of OA, with low (n = 9), moderate (n = 3), or high (n = 1) risk of bias. Seven studies used allogeneic MSCs (4 bone marrow, 1 umbilical cord, 1 placenta, 1 adipose tissue), 6 studies used autologous MSCs (3 adipose tissue, 2 bone marrow, 1 peripheral blood). Among the 11 studies examining cartilage outcomes, 10 found a benefit of MSCs on cartilage volume, morphology, quality, regeneration, and repair, assessed by magnetic resonance imaging, arthroscopy, or histology. The evidence for subchondral bone was consistent in all 3 studies in populations at risk of OA, showing beneficial effects. Sixteen unpublished, eligible trials were identified by searching trial registries, including 8 with actual or estimated completion dates before 2016.ConclusionOur systematic review of early-phase clinical trials demonstrated consistent evidence of a beneficial effect of intraarticular MSC injections on articular cartilage and subchondral bone. Due to the heterogeneity of MSCs, modest sample sizes, methodological limitations, and potential for publication bias, further work is needed before this therapy is recommended in the management of OA. |
| Databáze: | OpenAIRE |
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