Takeaway
- Patients with ischemic stroke who undergo stem cell transplantation experience a reduction in neurologic impairment but not in disability or dependency.
Why this matters
- 4 new trials reported since last systemic review nearly a decade ago.
Key results
- Follow-up ranged from 6 months to 7 years.
- Efficacy transplantation vs control:
- Better National Institutes of Health Scale score (mean difference, –1.49; 95% CI, –2.65 to –0.33).
- Similar modified Rankin Scale score (mean difference, –0.42; 95% CI, –0.86 to 0.02).
- Similar Barthel Index (mean difference, 14.09; 95% CI, –1.94 to 30.13).
- On average, trials favoring stem cell transplantation had higher risk for bias, smaller sample sizes.
- Transplantation did not increase risk for death (risk ratio, 0.66; 95% CI, 0.39-1.14).
- Sensitivity analysis by trial quality not possible because all had high bias risk.
Study design
- Cochrane systematic review of 7 randomized controlled trials among 401 patients with ischemic stroke in any phase (acute, subacute, chronic), ischemic lesion confirmed by CT or MRI.
- All types of stem cell transplantation included, regardless of cell source, route of administration, dosage.
- Main outcomes: efficacy (neurologic impairment or functional outcome) at ≥6-month follow-up.
- Funding: None disclosed.
Limitations
- Issues of low certainty of evidence, bias.
- Most trials were small.
References
References