1.
Platelet-rich plasma in the treatment of anal fistula: a systematic review and meta-analysis
Wang Y, Rao Q, Ma Y, Li X
International journal of colorectal disease. 2023;38(1):70
Abstract
OBJECTIVE To analyse the safety and effectiveness of platelet-rich plasma (PRP) in anal fistula patients. METHODS Online databases including PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to December 5, 2022, for eligible studies about evaluating the efficacy of platelet-rich plasma (PRP) in treating anal fistula. Literature search, screening, data extraction, and quality assessment were carried out by two independent investigators. The overall cure rate, the complete cure rate, the recurrence rate, and the adverse event rate with their 95% confidence intervals (95% CI) were the primary calculation indexes. Subgroup analyses were conducted primarily according to whether PRP was combined with other treatments. Softwares of MedCalc 18.2 and Review Manager 5.3 were used for meta-analysis. RESULTS A total of 14 studies with 514 patients were included in the meta-analysis. The overall cure rate of 14 studies was 72.11% (95% CI 0.64-0.79). The cure rate of PRP alone was 62.39% (95% CI 0.55-0.69). The combined cure rate of PRP with other treatments was 83.12% (95% CI 0.77-0.88). The cure rate of interventions involving PRP were superior to the cure rate of surgery methods without using PRP significantly in the 4 randomized controlled studies (RR = 1.30, 95% CI 1.10-1.54, p = 0.002). The complete cure rate of the 8 studies was 66.37% (95% CI 0.52-0.79). The recurrence rate of the 12 studies was 14.84% (95% CI 0.08-0.24). The adverse event rate of the 12 studies was 6.31% (95% CI 0.02-0.12). CONCLUSION PRP showed favorable safety and effectiveness in the treatment of anal fistula, especially combined with other treatment procedures.
2.
Use of platelet-rich plasma for COVID-19 related olfactory loss, a randomized controlled trial
Yan CH, Jang SS, Lin HC, Ma Y, Khanwalker AR, Thai A, Patel ZM
International forum of allergy & rhinology. 2022
Abstract
INTRODUCTION This study evaluated the use of platelet-rich plasma (PRP), an autologous blood product with supraphysiologic concentrations of growth factors, in the treatment of prolonged COVID-19 related smell loss. METHODS This multi-institutional, randomized controlled trial recruited COVID-19 patients with objectively measured smell loss (University of Pennsylvania's Smell Identification Test, UPSIT≤33) between 6-12 months. Subjects were randomized to 3 intranasal injections of either PRP or sterile saline into their olfactory clefts. Primary outcome measure was change in Sniffin' sticks score (TDI) from baseline. Secondary endpoint measures included responder rate (achievement of a clinically significant improvement, ≥5.5 point TDI), change in individual TDI olfaction scores, and change in subjective olfaction via a visual analogue scale. RESULTS 35 subjects were recruited and 26 completed the study. PRP treatment resulted in a 3.67 point (95% CI: 0.05-7.29, p = 0.047) greater improvement in olfaction compared to the placebo group at 3-months and a higher response rate (57.1% versus 8.3%, odds ratio 12.5, 95% exact bootstrap CI 2.2-116.7). There was a greater improvement in smell discrimination following PRP treatment compared to placebo, but no difference in smell identification or threshold. There was no difference in subjective scores between PRP and placebo. No adverse effects were reported. CONCLUSION Olfactory function following COVID-19 can improve spontaneously after 6 months and can improve to a greater extent with PRP injection. This data builds on the promise of PRP to be a safe potential treatment option for patients with COVID-19 smell loss, and larger-powered studies will help further assess efficacy. This article is protected by copyright. All rights reserved.
3.
Platelet-rich plasma injection vs corticosteroid injection for conservative treatment of rotator cuff lesions: A protocol for systematic review and meta-analysis
Wang C, Zhang Z, Ma Y, Liu X, Zhu Q
Medicine. 2021;100(7):e24680
Abstract
BACKGROUND To explore the effectiveness of platelet-rich plasma (PRP) injection regarding functional recovery, pain relief, and range of motion (ROM) of shoulder compared with the corticosteroid injection in patients with rotator cuff lesions treated non-operatively. METHODS An electronic literature search was performed by 2 authors in the PubMed, Embase, Cochrane Library, and Web of Science databases to identify relevant randomized controlled trial (RCTs) that were published up to July 20, 2020. The quality of the included RCTs was evaluated using the approach recommended by the Cochrane Handbook for Systematic Reviews of Interventions. Standardized mean differences (SMDs) or mean differences (MDs) with 95% confidence intervals (CIs) were applied to calculate the pooled effect sizes. RESULTS Six RCTs were included in this systematic review. Meta-analysis revealed that corticosteroid injection yielded statistically significant superior functional recovery (SMD = -0.80; 95% CI, -1.42 to -0.18; P = .01) and pain relief (MD = 1.59; 95% CI, 0.30-2.89; P = .02) compared with PRP injection for rotator cuff lesions during the short-term follow-up period. However, at the medium-term and long-term follow-up, no statistically significant difference was identified between the 2 groups. Regarding the ROM of shoulder, no statistically significant difference was found between the 2 groups during the whole follow-up period. CONCLUSIONS The current clinical evidence revealed short-term efficacy of corticosteroid injection and no significant medium- to long-term difference between corticosteroid and PRP injection in the treatment of rotator cuff lesions. Additional studies with longer follow-ups, larger sample sizes, and more rigorous designs are needed to draw more reliable and accurate conclusions.
4.
Intra-articular platelet-rich plasma injection for knee osteoarthritis: a summary of meta-analyses
Chen P, Huang L, Ma Y, Zhang D, Zhang X, Zhou J, Ruan A, Wang Q
Journal of orthopaedic surgery and research. 2019;14(1):385
Abstract
OBJECTIVE The purpose of this study was (1) to perform a summary of meta-analyses comparing platelet-rich plasma (PRP) injection with hyaluronic acid (HA) and placebo injection for KOA patients, (2) to determine which meta-analysis provides the best available evidence to making proposals for the use of PRP in the treatment of KOA patients, and (3) to highlight gaps in the literature that require future investigation. MATERIAL AND METHODS PubMed, EMBASE, and Cochrane databases search were performed for meta-analyses which compared PRP injection with HA or placebo. Clinical outcomes and adverse events were extracted from these meta-analyses. Meta-analysis quality was assessed using the Quality of Reporting of Meta-analyses (QUOROM) systems and the Oxman-Guyatt quality appraisal tool. The Jadad decision algorithm was also used to determine which meta-analysis provided the best available evidence. RESULTS Four meta-analyses were included in our study, and all of these articles were Level I evidence. The QUOROM score of each included meta-analysis range from 14 to 17 points (mean score 15, maximum score 18), and the Oxman-Guyatt score range from 4 to 6 points (mean score 5, maximum score 7). Three meta-analyses indicated PRP showed more benefit in pain relief and functional improvement than the control group, and the other one suggested no difference between these groups. All included meta-analyses found no statistical difference in adverse events between these groups. In addition, a meta-analysis conducted by Shen et al. got the highest methodological quality score and suggested that PRP provided better pain relief and function improvement in the treatment of KOA. CONCLUSIONS For short-term follow-up (≤1 year), intra-articular PRP injection is more effective in terms of pain relief and function improvement in the treatment of KOA patients than HA and placebo, and there is no difference in the risk of an adverse event between PRP and HA or placebo. LEVEL OF EVIDENCE Level I evidence, a summary of meta-analyses TRIAL REGISTRATION PROSPERO ID CRD42018116168.