Peripheral blood derived stem cells in OA knee at low resource setting: a phase II RCT

Abstract

validity of current animal studies, high quality experimental studies and efforts for effective translation from preclinical studies to clinical trials are still required. The present study also demonstrates that moderate confidence could be placed in safety of MSCs therapy for knee OA but with low confidence in efficacy outcomes due to limitations of the current evidence. Further high-quality studies with high internal and external validity are still required.

Mesenchymal stem cells in knee osteoarthritis treatment: A systematic review and meta-analysis

“…Nineteen studies including 584 knee OA patients (352 cases for MSC group and 232 cases for control group) fulfilled the predefined inclusion criteria and were included in the final analysis ( Figure 1 ). Eighteen publications were full-text articles [ [2] , [3] , [4] , [5] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , 21 , 23 ], and one publication was conference abstract [ 6 ].

Figure 1 Flow diagram of studies identified, included and excluded.

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“…The characteristics of included studies are shown in Table 1 . Among the included studies, there were 15 RCTs [ 3 , 5 , 6 , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , 18 , 19 , 21 , 23 ], two retrospective studies [ 1 , 17 ] and two cohort studies [ 4 , 16 ]. All the 19 papers were fully published during the period from 2012 to 2019.…”

“…Sample size ranged from a minimum of nine to a maximum of 60 patients. In all the trials, MSC therapy was evaluated in knee OA patients with MSCs from fat in nine studies [ 1 , 4 , 8 , 13 , [15] , [16] , [17] , [18] , [19] ], MSCs from marrow in five studies [ 3 , [9] , [10] , [11] , 14 ], peripheral blood stem cells in one study reported in a conference paper [ 21 ], and MSCs from foetus in four studies [ 5 , 6 , 12 , 23 ]. The patients received cell infusions from 1.89 × 10 6 to 100 × 10 6 cells.…”

“… 2019 20 (11/9) 10 (5/5) 54.6/51.5 31.6 RCT WOMAC 12 Fat ROB 95.1–103.9 MSCs/NS [ 19 ] Khasru et al. 2019 15 15 53 ± 11 — RCT WOMAC, VAS 6 Blood ROB — MSCs [ 21 ] Matas et al. 2019 20 (9/11) 9 (4/5) 56.1 ± 6.8/54.8 ± 4.5 27.6 RCT WOMAC, VAS, SF-36 12 Foetus ROB 20 MSCs/NS/HA [ 23 ] BMI = body mass index; CS = cohort study; HA = hyaluronic acid; KOA = knee osteoarthritis; KOOS = knee osteoarthritis outcome score; MSCs = mesenchymal stem cells; NOS = Newcastle–Ottawa Scale; NS = normal saline; PRP = platelet-rich plasma; R = retrospective; RCT = randomized controlled trial; ROB = The Cochrane collaboration's tool for assessing risk of bias; RP = retrospective design, prospective data collection; SF-36 = short form–36 health survey; VAS = visual analog scale; WOMAC = Western Ontario and McMaster Universities Osteoarthritis Index.…”

Accentuating the sources of mesenchymal stem cells as cellular therapy for osteoarthritis knees—a panoramic review

“…A recent review article established the use of PBMSCs in cartilage repair and regeneration to be very safe and efficacious (94). In phase II clinical trial on the use of PBSCs in an arthritic knee, it was found that these cells increase the mean cartilage thickness and improve the quality of life (95).…”