This site is intended for UK healthcare professionals
Medscape UK Univadis Logo
Medscape UK Univadis Logo
Clinical Summary

Cochrane: stem cell benefit uncertain in ischemic stroke

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

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


YOU MAY ALSO LIKE