Efficacy and safety of platelet‐rich plasma in treating cutaneous ulceration: A meta‐analysis of randomized controlled trials

Shen, Zhen; Zheng, Shengpeng; Guo-qian, Chen; Ding, Li; Jiang, Ziwei; Li, Yue; Huang, Feng

doi:10.1111/jocd.12853

Cited by 13 publications

(12 citation statements)

References 61 publications

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“…The risk of each item is categorized into three levels: high, unclear, and low. We also determined the publication bias by using Begg's test and Egger's test (Shen et al, 2019 ).…”

Section: Methodsmentioning

confidence: 99%

Effect of Pilates on Glucose and Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Chen

Xia

et al. 2021

Front. Physiol.

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Objective: The benefits of Pilates for blood glucose and lipids remain unclear. The purpose of this study was to examine the effect of Pilates on their levels.Methods: Searches were conducted in five databases to identify relevant articles published until October 29, 2020. Paired reviewers independently screened the articles and extracted data from each included study. Meta-analysis was performed to assess the effects of Pilates on blood glucose and lipids. Subgroup analyses and sensitivity analyses were conducted to explore heterogeneity.Results: According to the inclusion and exclusion criteria, 15 randomized controlled trials (RCTs) comprising 587 participants were included in the study. Overall, the Pilates group (PG) had a significantly greater reduction in post-prandial blood glucose than the control group (CG) (MD = −22.25 mg/dL, 95% CI: [−28.34, 16.17] mg/dL, P < 0.00001, I2 = 0%); glycated hemoglobin (HbA1c) (MD = −0.78%, 95% CI: [−1.13, −0.42]%, P < 0.0001, I2 = 88%); total cholesterol (TC) (MD = −20.90 mg/dL, 95% CI: [−37.21, −4.60] mg/dL, P = 0.01, I2 = 84%); triglycerides (TG) (MD = −12.59 mg/dL, 95% CI: [−19.88, −5.29] mg/dL, P = 0.0007, I2 = 86%); and low density lipoprotein cholesterol (LDL-C) (MD = −12.39 mg/dL, 95% CI: [−16.82, −7.95] mg/dL, P < 0.00001, I2 = 45%) compared to CG, whereas no significant difference was detected between the two groups in fasting blood glucose (MD = −7.04 mg/dL, 95% CI: [−17.26, 3.17] mg/dL, P = 0.18, I2 = 93%), insulin (MD = −1.44 μU/mL, 95% CI: [−4.30, 1.41] μU/mL, P = 0.32, I2 = 0%); and high density lipoprotein cholesterol (HDL-C) (MD = −2.68 mg/dL, 95% CI: [−9.03, 3.67] mg/dL, P = 0.41, I2 = 89%). However, by subgroup analysis, we found that compared to the CG, PG showed no significant improvement in blood glucose and lipids levels for non-diabetics, while it presented a significantly greater decrease in post-prandial blood glucose, TC, TG, and LDL-C for diabetic patients. Notably, for diabetic patients, Pilates and medication treatments showed no significant reduction in fasting blood glucose (MD = −7.00 mg/dL, 95% CI: [−26.06, 12.06] mg/dL, P = 0.40) and HbA1c (MD = −0.23%, 95% CI: [−0.58, 0.13]%, P = 0.21, I2 = 0%) than medications treatment used alone, and Pilates combined with medications and dietary treatments presented no significant improvement in fasting blood glucose than a combination of medications and dietary treatments (MD = −10.90 mg/dL, 95% CI: [−32.35, 10.54] mg/dL, P = 0.32, I2 = 94%).Conclusions: Overall, Pilates could improve post-prandial blood glucose, fasting blood glucose, HbA1c, TG, TC, and LDL-C for diabetic patients, which could be influenced by its duration and intensity. Moreover, it had no significant effect on blood glucose and lipids for non-diabetic individuals. However, Pilates, as an adjunctive treatment to medications was not superior to medications used alone in lowering fasting blood glucose and HbA1c. Furthermore, Pilates combined with medications and dietary treatments showed no significant improvement in fasting blood glucose, whereas it had a greater reduction in post-prandial blood glucose and HbA1c for diabetic patients.Systematic Review Registration:https://osf.io/xgv6w.

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“…The risk of each item is categorized into three levels: high, unclear, and low. We also determined the publication bias by using Begg's test and Egger's test (Shen et al, 2019 ).…”

Section: Methodsmentioning

confidence: 99%

Effect of Pilates on Glucose and Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Chen

Xia

et al. 2021

Front. Physiol.

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“…Two investigators (ZC and WC) assessed the Cochrane Collaboration risk of bias table (23) and the quality of the literature using the Jadad score scale (24). We also examined the public bias using Begg's test and Egger's test (25).…”

Section: Risk Of Bias and Quality Assessmentmentioning

confidence: 99%

Effect of Pilates on Sleep Quality: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Chen

Shen

et al. 2020

Front. Neurol.

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Objective: Pilates exercise is increasingly used to improve sleep quality, but relevant evidence remains unclear. We aimed to estimate the effect of Pilates on sleep quality.Methods: Five databases were searched for articles published until 10 December 2019. Two investigators screened the articles and extracted data from each included study. A meta-analysis was performed to evaluate the effect of Pilates on sleep quality, assessed using the Pittsburgh Sleep Quality Index (PSQI).Results: Six randomized controlled trials (RCTs) comprising 477 participants were included according to the inclusion and exclusion criteria in the study. All included studies reported the positive effects Pilates had on sleep quality. The Pilates group (PG) significantly lowered the PSQI total score (MD = −3.60, 95%CI: [−5.41, −1.78), P = 0.0001, I 2 = 97%) compared to the non-exercising control group (CG), whereas no significant improvement in use of sleep medication was observed (MD = −0.33, 95%CI: [−0.73, −0.06), P = 0.10, I 2 = 68%). However, in a subgroup analysis, we found that there was no significant reduction in the PSQI total score for healthy participants over 40 years old (MD = −3.73, 95%CI: [−7.89, 0.42], P = 0.08, I 2 = 98%) and for postmenopausal women (MD = −5.55, 95%CI: [−13.98, −2.89], P = 0.20, I 2 = 98%). Conclusions:Overall, Pilates improved sleep quality but had no significant effect on the use of sleep medication. However, Pilates showed no significant impact on sleep quality for healthy individuals over 40 years old and for postmenopausal women. Well-designed and large-scale RCTs are needed in the future.

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“…25 The most recent meta-analyses and review articles have highlighted the therapeutic potential of PRP in chronic wounds with demonstrated benefits in several clinical outcomes, notably complete wound closure, wound surface reduction, scar reduction, and a lowering of incidence of infections. [26][27][28][29][30][31][32][33][34] The clinical results of PRP effectiveness in the treatment of DFU are promising considering, however, that the costs associated with treating DFUs with PRP are presumably higher than using standard therapy. Therefore, the implementation of this therapeutic approach in health systems should be based on its cost-effectiveness.…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness Analysis for the Treatment of Diabetic Foot Ulcer in France: Platelet-Rich Plasma vs Standard of Care

Russo

Landi

Courric³

2022

CEOR

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Introduction: Diabetic chronic foot ulcers (DFU) lead to pain, reduced quality of life and represent a severe economic burden for patients and health systems. The clinical results of PRP effectiveness in the treatment of DFU are promising; on the other hand, the costs associated with treating DFUs with PRP are higher than those using standard therapy. Therefore, this study aims to determine the cost-effectiveness of platelet-rich plasma (PRP) therapy compared to standard therapy from the French healthcare system perspective. Methods: A cost-effectiveness analysis (CEA) was performed using a decision Markov model with a cohort of patients with chronic DFU (duration of >3 weeks) with high orthopaedic risk and with ulcers graded 3A according to University of Texas classification. The effectiveness outcomes are reported in terms of quality adjusted life year (QALY). The costs are reported in euro (€) currency evaluated in 2019. A micro-costing approach alongside a clinical study was used to assess resource use. Deterministic sensibility analyses are reported to evaluate the robustness of the results. The analyses were carried out in the French setting. Results:The incremental cost-effectiveness ratio (ICER) of PRP treatment is -€613/ QALY, which, being lower than zero, indicates the dominance of the PRP therapy. Deterministic and probabilistic sensitivity analysis underlines the main parameter affecting CE results. Lowest number of standard of care weekly medications (from 5 to 3) leads to a €622/QALY while increasing PRP weekly medication (from 1 to 4) has an ICER of €732/QALY. Discussion: PRP is a cost-effective or even a cost-saving alternative in the French setting. PRP has higher cost for the complete medication, but, in the absence of wound complications, has the potential to involve lower consumption of resources in the form of routine medication over a 1-year time horizon.

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Efficacy and safety of platelet‐rich plasma in treating cutaneous ulceration: A meta‐analysis of randomized controlled trials

Cited by 13 publications

References 61 publications

Effect of Pilates on Glucose and Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Effect of Pilates on Glucose and Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Effect of Pilates on Sleep Quality: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cost-Effectiveness Analysis for the Treatment of Diabetic Foot Ulcer in France: Platelet-Rich Plasma vs Standard of Care

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