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Meta-Analysis
. 2024 Jan;45(1):65-74.
doi: 10.1007/s10072-023-07032-z. Epub 2023 Sep 21.

A review and meta-analysis of stem cell therapies in stroke patients: effectiveness and safety evaluation

L Hovhannisyan  1   2 , S Khachatryan  1 , A Khamperyan  1 , S Matinyan  3   4
Affiliations
Meta-Analysis

A review and meta-analysis of stem cell therapies in stroke patients: effectiveness and safety evaluation

L Hovhannisyan et al. Neurol Sci. 2024 Jan.

Abstract

Purpose: Stem cells have been extensively used during the last decade to improve clinical outcomes after stroke. The dramatic increase in trials in this field has led us to perform a systematic review and meta-analysis to understand the safety, effectiveness, and relative limitations of this type of intervention.

Method: This review summarizes the current evidence pooled from PubMed (Medline), EMBASE, EBSCOhost, http://clinicaltrials.gov , Scopus (Elsevier), Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science (Science Citation Index Expanded) databases for the use of stem cell therapies in stroke patients without combinations with other treatment modalities. The National Institutes of Health Stroke, modified Rankin Scales, and Barthel Index scores after external stem cell administration have been evaluated on the 3rd, 6th, and 12th months after treatment. The random effect analysis was performed using the Review Manager 5.4.1. The characteristics of stem cell sources and their adverse effects have been discussed as well.

Findings: Although reasonably safe, the effectiveness evidence fluctuated to a large extent due to the heterogeneity of the clinical trials and the absence of a systematic approach. The stem cell sources and the administration window were not strongly associated with clinical outcomes.

Conclusion: Further studies should be conducted to understand the deep discrepancy between preclinical and clinical trials and to execute phase 3 clinical trials with robust control of study characteristics and outcomes.

Keywords: BI; NIHSS; Stem cell; Stroke; mRS.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The PRISMA workflow. 14 studies for NIHSS, 14 studies for BI, and 11 studies for mRS were used for quantitative synthesis
Fig. 2
Fig. 2
Forest plot of post-treatment NIHSS score change after 3, 6, and 12 months in studies without (a, b, c) and with comparator arm (d, e, f) respectively
Fig. 3
Fig. 3
Forest plot of post-treatment BI score change after 3, 6, and 12 months in studies without (a, b, c) and with comparator arm (d, e, f), respectively
Fig. 4
Fig. 4
Forest plot of post-treatment mRS score change after 3, 6, and 12 months in studies without (a, b, c) and with comparator arm (d, e, f), respectively
Fig. 5
Fig. 5
Risk of bias summary. The cumulative risk of bias pooled from included studies
See this image and copyright information in PMC

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