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Clinical Summary

KOA: benefit is lacking for intra-articular injection of culture-expanded MSCs

Takeaway

  • For intra-articular injection of culture-expanded mesenchymal stem cells (MSCs) without adjuvant surgery, evidence of efficacy is lacking for most outcomes except pain reduction, according to a small meta-analysis.

Why this matters

  • No available therapies modify or delay the pathophysiology of osteoarthritis.
  • The results of this meta-analysis may lessen demand for MSCs and encourage more research.

Study design

  • A meta-analysis of 6 randomized controlled trials (N=203).
  • Funding: Korea Health Technology R&D Project provided author funding.

Key results

  • MSC injection (vs controls) was associated with:
    • Reduced pain by visual analog scale (VAS) at 12 months: mean difference (MD), −13.55 (95% CI, −22.19 to −4.9).
    • Reduced cumulative pain by VAS and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score: standardized MD (SMD), −0.54 (95% CI, −0.85 to −0.23).
  • No improvement was seen in:
    • Cartilage repair assessed by MRI: SMD, 0.11 (95% CI, −0.51 to 0.73).
    • Whole-Organ Magnetic Resonance Imaging Score: MD, 1.68 (95% CI, −14.84 to 18.21).
    • Categorical results: OR, 1.56 (P=.58).
    • Function by total WOMAC score: SMD, −0.63 (P=.08).

Limitations

  • Heterogeneity across studies.

References


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