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. 2015 Apr 29;10(4):e0125032.
doi: 10.1371/journal.pone.0125032. eCollection 2015.

Therapeutic Efficacy of Stem Cell-based Therapy in Peripheral Arterial Disease: A Meta-Analysis

Yumeng Liu  1 , Yunyun Xu  2 , Fang Fang  2 , Jianting Zhang  3 , Liang Guo  1 , Zhen Weng  3
Affiliations

Therapeutic Efficacy of Stem Cell-based Therapy in Peripheral Arterial Disease: A Meta-Analysis

Yumeng Liu et al. PLoS One. .

Abstract

Several cell-based therapies for peripheral arterial disease (PAD) have been studied in multiple clinical trials; however, the outcome of this treatment remains controversial. The aim of this study was to perform a meta-analysis of the clinical trials on stem cell-based therapy after PAD. We searched for clinical trials that investigated the effect of stem cell-based therapy on patients with PAD and were published between January 2000 and October 2014. The outcomes of interest comprised all-cause mortality, amputation rate, ulcer healing, and ankle-brachial index (ABI). In addition, pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the safety and efficacy of the stem cell-based therapies for PAD. Thirteen studies were retrieved from 261 citations for the analysis, and in total, 527 patients (mean age: 64.2 years; median follow up: 6 months) were included in the analysis. After synthesizing data, the meta-analysis showed significant improvement in the amputation rate (OR=0.33, 95%CI=0.22-0.51; P<0.001), ulcer healing (OR=6.11, 95%CI=3.04-12.28; P<0.001), and ABI (SMD=0.65, 95%CI=0.33-0.97; P<0.001) for the stem cell-based therapy group compared with the controls. Moreover, significant improvement in the amputation rate, ulcer healing, and ABI were also found based on the time point and stem cell source. In addition, no significant difference was found in the all-cause mortality (OR=0.80, 95%CI=0.39-1.641; P=0.546) between the stem cell-based therapy and control groups. Therefore, according to the results of our meta-analysis, stem cell-based therapy is safe and shows a beneficial outcome for patients with PAD, especially in the short term.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of study inclusion.
Fig 2
Fig 2. Risk of bias summary.
Fig 3
Fig 3. Forest plots of amputation (A), ulcer healing (B) and the ankle-brachial index (ABI) (C) over time.
Amputation and ulcer healing were calculated using a fixedeffects model, while ABI was calculated using arandomeffects model. CI:confidence interval; OR:odds ratio.
Fig 4
Fig 4. Forest plots of amputation (A), ulcer healing (B) and the ankle-brachial index (ABI) (C) usingcells from different sources.
Amputation and ulcer healing were calculated using afixedeffects model, while ABI was calculated using a randomeffects model. CI:confidence interval; OR:odds ratio.
Fig 5
Fig 5. Begg’s funnel plot for amputation.
logOR: logarithm of odds ratio; s.e.:standard error.
See this image and copyright information in PMC

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