Wei Ding1, Yong-Qing Xu2, Ying Zhang2, An-Xu Li2, Xiong Qiu2, Hong-Jie Wen3, Hong-Bo Tan2. 1. Medical College, Yunnan University of Business Management, Kunming, Yunnan, People's Repuplic of China. 2. Department of Orthopaedic, The 920th Hospital of Joint Logistics Support Force, Kunming, Yunnan, People's Republic of China. 3. Department of Orthopedic Surgery, The Fourth Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, Peoples' Republic of China.
Abstract
OBJECTIVE: Osteoarthritis (OA) is a chronic joint disease characterized by degeneration of articular cartilage and secondary osteogenesis. Cell-based agents, such as mesenchymal stem cells, have turned into the most extensively explored new therapeutic agents for OA. However, evidence-based research is still lacking. METHODS: We searched public databases up to February 2020 and only included randomized controlled trials. The outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Knee Injury and Osteoarthritis Outcome Score (KOOS), the visual analogue scale (VAS) score, and serious adverse events (SAEs). A network meta-analysis was also performed in this work. RESULTS: We included 13 studies in the meta-analysis. The effect size showed that cell-based therapy did not significantly reduce the WOMAC score at the 6-month follow-up (standard mean difference [SMD] -3.6; 95% confidence interval [CI] -0.90 to 0.18; P = 0.1928). However, cell-based therapy significantly improved the KOOS at the 12-month follow-up (SMD 0.68; 95% CI 0.07-1.30; P = 0.0288) and relieved pain (SMD -1.05; 95% CI -1.46 to -0.64; P < 0.0001). The findings also indicated that high-dosage adipose-derived mesenchymal stem cells (ADMSCs) may be more advantageous in terms of long-term effects. CONCLUSIONS: Cell-based therapy had a better effect on KOOS improvement and pain relief without safety concerns. However, cell-based therapy did not show a benefit in terms of the WOMAC. Allogeneic cells might have advantages compared to controls in the WOMAC and KOOS scores. The long-term effect of high-dose ADMSC treatment for OA is worthy of further study.
OBJECTIVE: Osteoarthritis (OA) is a chronic joint disease characterized by degeneration of articular cartilage and secondary osteogenesis. Cell-based agents, such as mesenchymal stem cells, have turned into the most extensively explored new therapeutic agents for OA. However, evidence-based research is still lacking. METHODS: We searched public databases up to February 2020 and only included randomized controlled trials. The outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Knee Injury and Osteoarthritis Outcome Score (KOOS), the visual analogue scale (VAS) score, and serious adverse events (SAEs). A network meta-analysis was also performed in this work. RESULTS: We included 13 studies in the meta-analysis. The effect size showed that cell-based therapy did not significantly reduce the WOMAC score at the 6-month follow-up (standard mean difference [SMD] -3.6; 95% confidence interval [CI] -0.90 to 0.18; P = 0.1928). However, cell-based therapy significantly improved the KOOS at the 12-month follow-up (SMD 0.68; 95% CI 0.07-1.30; P = 0.0288) and relieved pain (SMD -1.05; 95% CI -1.46 to -0.64; P < 0.0001). The findings also indicated that high-dosage adipose-derived mesenchymal stem cells (ADMSCs) may be more advantageous in terms of long-term effects. CONCLUSIONS: Cell-based therapy had a better effect on KOOS improvement and pain relief without safety concerns. However, cell-based therapy did not show a benefit in terms of the WOMAC. Allogeneic cells might have advantages compared to controls in the WOMAC and KOOS scores. The long-term effect of high-dose ADMSC treatment for OA is worthy of further study.
Authors: Rushabh M Vakharia; Martin W Roche; Jose Carlos Alcerro; Carlos Jesus Lavernia Journal: Orthop Clin North Am Date: 2019-08-06 Impact factor: 2.472
Authors: Julian P T Higgins; Douglas G Altman; Peter C Gøtzsche; Peter Jüni; David Moher; Andrew D Oxman; Jelena Savovic; Kenneth F Schulz; Laura Weeks; Jonathan A C Sterne Journal: BMJ Date: 2011-10-18
Authors: José María Lamo-Espinosa; Gonzalo Mora; Juan F Blanco; Froilán Granero-Moltó; Jorge María Núñez-Córdoba; Silvia López-Elío; Enrique Andreu; Fermín Sánchez-Guijo; José Dámaso Aquerreta; José María Bondía; Andrés Valentí-Azcárate; María Del Consuelo Del Cañizo; Eva María Villarón; Juan Ramón Valentí-Nin; Felipe Prósper Journal: J Transl Med Date: 2018-07-31 Impact factor: 5.531
Authors: Jose Matas; Mario Orrego; Diego Amenabar; Catalina Infante; Rafael Tapia-Limonchi; Maria Ignacia Cadiz; Francisca Alcayaga-Miranda; Paz L González; Emilio Muse; Maroun Khoury; Fernando E Figueroa; Francisco Espinoza Journal: Stem Cells Transl Med Date: 2018-12-28 Impact factor: 6.940
Authors: Sebastián Cruz Rodriguez-García; Raul Castellanos-Moreira; Jacqueline Uson; Esperanza Naredo; Terence W O'Neill; Michael Doherty; Mikael Boesen; Hemant Pandit; Ingrid Möller Parera; Valentina Vardanyan; Lene Terslev; Will Uwe Kampen; Maria Antonieta D'Agostino; Francis Berenbaum; Elena Nikiphorou; Irene Pitsillidou; Jenny de la Torre-Aboki; Loreto Carmona Journal: RMD Open Date: 2021-06
Authors: Christoph Schmitz; Christopher Alt; David A Pearce; John P Furia; Nicola Maffulli; Eckhard U Alt Journal: Cells Date: 2022-03-11 Impact factor: 6.600