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

Abstract

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.