A Network Meta-Analysis of Randomized Controlled Trials on the Comparative Efficacy of Stem Cells Therapy for Diabetic Foot Ulcer Healing.
Shiv Kumar Mudgal, Subodh Kumar, Suresh K Sharma et al.
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In 30 seconds
This network meta-analysis compared stem-cell interventions for healing diabetic foot ulcers in adults, drawing on 18 clinical trials and 13 interventions. Most interventions were associated with significantly greater chances of ulcer healing than their comparators. The highest-ranked options included human viable wound matrix (RR 2.91; CI: 1.28, 6.64), peripheral blood mononuclear cells (RR 2.35; CI: 1.21, 4.55), and bone marrow mesenchymal stem cells (RR 2.20; CI: 1.34, 3.60). The authors noted that differences between leading options were not significant and that many studies had some concern or high risk of bias.
Key findings
- Human viable wound matrix ranked among the leading options for ulcer healing (RR 2.91; CI: 1.28, 6.64).
- Peripheral blood mononuclear cells were also highly ranked (RR 2.35; CI: 1.21, 4.55).
- Bone marrow mesenchymal stem cells showed increased healing chances (RR 2.20; CI: 1.34, 3.60).
- Risk-of-bias assessment found some concern or high risk among the majority of studies.
Why it matters
The analysis brings together comparative evidence across multiple stem-cell approaches, which may help frame research priorities for diabetic foot ulcer healing. However, rankings should not be interpreted as proof that one intervention is superior: the authors report no significant differences between leading options, and the underlying studies commonly had risk-of-bias concerns.
What to keep in mind
The authors report some concern or high risk of bias in most included studies and state that further studies are needed to establish whether leading interventions differ in efficacy.