Methodological Flaws in Meta-Analyses of Clinical Studies on the Management of Knee Osteoarthritis with Stem Cells: A Systematic Review.


Journal

Cells
ISSN: 2073-4409
Titre abrégé: Cells
Pays: Switzerland
ID NLM: 101600052

Informations de publication

Date de publication:
11 03 2022
Historique:
received: 17 02 2022
revised: 08 03 2022
accepted: 09 03 2022
entrez: 25 3 2022
pubmed: 26 3 2022
medline: 14 4 2022
Statut: epublish

Résumé

(1) Background: Conclusions of meta-analyses of clinical studies may substantially influence opinions of prospective patients and stakeholders in healthcare. Nineteen meta-analyses of clinical studies on the management of primary knee osteoarthritis (pkOA) with stem cells, published between January 2020 and July 2021, came to inconsistent conclusions regarding the efficacy of this treatment modality. It is possible that a separate meta-analysis based on an independent, systematic assessment of clinical studies on the management of pkOA with stem cells may reach a different conclusion. (2) Methods: PubMed, Web of Science, and the Cochrane Library were systematically searched for clinical studies and meta-analyses of clinical studies on the management of pkOA with stem cells. All clinical studies and meta-analyses identified were evaluated in detail, as were all sub-analyses included in the meta-analyses. (3) Results: The inconsistent conclusions regarding the efficacy of treating pkOA with stem cells in the 19 assessed meta-analyses were most probably based on substantial differences in literature search strategies among different authors, misconceptions about meta-analyses themselves, and misconceptions about the comparability of different types of stem cells with regard to their safety and regenerative potential. An independent, systematic review of the literature yielded a total of 183 studies, of which 33 were randomized clinical trials, including a total of 6860 patients with pkOA. However, it was not possible to perform a scientifically sound meta-analysis. (4) Conclusions: Clinicians should interpret the results of the 19 assessed meta-analyses of clinical studies on the management of pkOA with stem cells with caution and should be cautious of the conclusions drawn therein. Clinicians and researchers should strive to participate in FDA and/or EMA reviewed and approved clinical trials to provide clinically and statistically valid efficacy.

Identifiants

pubmed: 35326416
pii: cells11060965
doi: 10.3390/cells11060965
pmc: PMC8946093
pii:
doi:

Types de publication

Journal Article Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

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Auteurs

Christoph Schmitz (C)

Chair of Anatomy II, Institute of Anatomy, Faculty of Medicine, Ludwig-Maximilians University, 80336 Munich, Germany.

Christopher Alt (C)

Isar Klinikum, General Management, 80331 Munich, Germany.
InGeneron Inc., Houston, TX 77054, USA.
Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD 57105, USA.

David A Pearce (DA)

Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD 57105, USA.
Sanford Health, Sioux Falls, SD 57117, USA.
Sanford Research, Sioux Falls, SD 57105, USA.

John P Furia (JP)

SUN Orthopedics of Evangelical Community Hospital, Lewisburg, PA 17837, USA.

Nicola Maffulli (N)

Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, 84084 Fisciano, Italy.
Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, London E1 2AD, UK.
School of Pharmacy and Bioengineering, Guy Hilton Research Centre, Keele University School of Medicine, Stoke on Trent ST4 7QB, UK.

Eckhard U Alt (EU)

Isar Klinikum, General Management, 80331 Munich, Germany.
InGeneron Inc., Houston, TX 77054, USA.
Sanford Research, Sioux Falls, SD 57105, USA.
Heart and Vascular Institute, Department of Medicine, Tulane University Health Science Center, New Orleans, LA 70112, USA.

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