1.
Efficacy and Safety of COVID-19 Treatment Using Convalescent Plasma Transfusion: Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials
Lee HJ, Lee JH, Cho Y, Ngoc LTN, Lee YC
International journal of environmental research and public health. 2022;19(17)
Abstract
This study investigated the efficacy and safety of convalescent plasma (CP) transfusion against the coronavirus disease 2019 (COVID-19) via a systematic review and meta-analysis of randomized controlled trials (RCTs). A total of 5467 articles obtained from electronic databases were assessed; however, only 34 RCTs were eligible after manually screening and eliminating unnecessary studies. The beneficial effect was addressed by assessing the risk ratio (RR) and standardized mean differences (SMDs) of the meta-analysis. It was demonstrated that CP therapy is not effective in improving clinical outcomes, including reducing mortality with an RR of 0.88 [0.76; 1.03] (I(2) = 68% and p = 0.10) and length of hospitalization with SMD of -0.47 [-0.95; 0.00] (I(2) = 99% and p = 0.05). Subgroup analysis provided strong evidence that CP transfusion does not significantly reduce all-cause mortality compared to standard of care (SOC) with an RR of 1.01 [0.99; 1.03] (I(2) = 70% and p = 0.33). In addition, CP was found to be safe for and well-tolerated by COVID-19 patients as was the SOC in healthcare settings. Overall, the results suggest that CP should not be applied outside of randomized trials because of less benefit in improving clinical outcomes for COVID-19 treatment.
2.
Autologous platelet-rich plasma versus dextrose prolotherapy for the treatment of chronic recalcitrant plantar fasciitis
Kim E, Lee JH
Pm & R. 2014;6((2):):152-8.
Abstract
OBJECTIVE To determine the efficacy of autologous platelet-rich plasma (PRP) compared with dextrose prolotherapy (DP) in patients with chronic recalcitrant plantar fasciitis (PF) DESIGN A single-blinded, randomized, controlled study. SETTING Department of Physical Medicine and Rehabilitation of a university hospital. PARTICIPANTS Twenty-one patients with a clinical diagnosis of chronic PF confirmed by diagnostic ultrasound (plantar fascia thickness >4 mm) were randomly assigned to the PRP group (n = 10) or the DP group (n = 11). INTERVENTIONS Each patient received 2 injections into the plantar fascia through a peppering technique under ultrasound guidance at an interval of 2 weeks, either with 2 mL of autologous PRP or 2 mL of 15% dextrose/lidocaine solution. MAIN OUTCOME MEASUREMENTS The outcome measures included the pain, disability, and activity limitation subscales, measured by means of the Foot Functional Index. Data were collected before the first injection, at 2 weeks (before the second injection), and at the 2- and 6-month follow-ups. RESULTS All patients completed the follow-ups, with the exception of 1 patient in the PRP group. The mean Foot Functional Index total and subcategory score improvements were greater in the PRP group compared with the DP group (improvement with PRP vs DP, total: 30.4% vs 15.1%, pain: 29.7% vs 17.1%, disability: 26.6% vs 14.5%, activity limitation: 28.0% vs 12.4%). However, no statistically significant difference was noted at any follow-up. In the pain and disability subcategories, both groups showed significant improvements at the last re-evaluation. The PRP group also showed significant improvements in the disability and activity limitation subscales at the second re-evaluation. CONCLUSIONS Each treatment seems to be effective for chronic recalcitrant PF, expanding the treatment options for patients in whom conservative care has failed. PRP treatment also may lead to a better initial improvement in function compared with DP treatment. Copyright 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
3.
Platelet-rich plasma combined with fractional laser therapy for skin rejuvenation
Shin MK, Lee JH, Lee SJ, Kim NI
Dermatologic Surgery. 2012;38((4):):623-30.
Abstract
BACKGROUND AND OBJECTIVES Platelet-rich plasma (PRP) is an autologous concentration of human platelets contained in a small volume of plasma and has recently been shown to accelerate wound healing and rejuvenate aging skin. The current study was conducted to determine whether there are additional effects of PRP combined with fractional laser therapy. MATERIALS AND METHODS Twenty-two Korean women underwent three sessions of fractional laser; 11 were treated with topical application of PRP combined with fractional laser. Evaluations were done at baseline and 1 month after the final treatment. The outcome assessments included subjective satisfaction scale; blinded clinical assessment; and the biophysical parameters of roughness, elasticity, skin hydration, and the erythema and melanin index. Biopsies were analyzed using hematoxylin and eosin, Masson-trichrome, and immunohistochemistry for matrix metalloproteinase-1. RESULTS PRP combined with fractional laser increased subject satisfaction and skin elasticity and decreased the erythema index. PRP increased the length of the dermoepidermal junction, the amount of collagen, and the number of fibroblasts. CONCLUSION PRP with fractional laser treatment is a good combination therapy for skin rejuvenation. Keratinocyte and fibroblast proliferation and collagen production can explain the capacity of PRP to increase dermal elasticity. 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.
4.
A randomized trial of anemia correction with two different hemoglobin targets in the first-line chemotherapy of advanced gastric cancer
Park SH, Nam E, Bang SM, Cho EK, Shin DB, Lee JH
Cancer Chemotherapy and Pharmacology. 2008;62((1):):1-9.
Abstract
PURPOSE To evaluate if raising baseline and maintaining hemoglobin (Hb) levels with red blood cell (RBC) transfusion could improve the outcomes of chemotherapy for advanced gastric cancer (AGC). METHODS Patients were randomized to receive RBC transfusion to maintain their Hb levels >or=10 g/dl (arm 1) or >or=12 (arm 2) before the start of their 5-fluorouracil-based first-line chemotherapy. Objective response, KPS and quality of life (QOL) data were measured. RESULTS For 87 patients enrolled, mean baseline Hb was 10. 1 g/dl, and 54 patients received RBC prior to chemotherapy initiation. Despite transfusion, we failed to maintain the Hb level above the predefined target range. Eighteen patients experienced brief and reversible adverse events during transfusion, including two patients with acute pulmonary edema. KPS was improved from baseline to post-chemotherapy in both arms. QOL data showed improvement in some symptom scores, but there was no difference in the QOL scores between the two arms at baseline and all four cycles of treatment. Similar response rates were observed in both arms (arm 1, 30%; arm 2, 35%). Both arms showed similar chemotherapy duration (3. 8 and 4. 1 months, respectively), progression-free survival (4. 0 and 4. 1 months) and overall survival (9. 9 and 9. 3 months). CONCLUSIONS Red blood cell transfusion achieving Hb level above 10 g/dl might contribute to the improvement of the KPS and QOL seen in patients with AGC. The observation of equivalent outcomes at the two target Hb levels supports the feasibility of anemia correction to Hb 10 g/dl, which merits further evaluation.