Mesenchymal stem cells for perianal fistulizing Crohn’s disease (systematic review and meta-analysis)

Abstract

   AIM: to compare the efficacy (fistulas healing rate) and safety (morbidity rate) of mesenchymal stem cells (MSC) and placebo in patients with perianal fistulizing Crohn’s disease (PFCD).   PATIENTS AND METHODS: a systematic review and meta-analysis of clinical trials, comparing the results of treatment of PFCD with single local administration of MSCs or placebo was performed. The meta-analysis included 5 randomized clinical trials and the results of treatment of 289 patients were analyzed.   RESULTS: the meta-analysis demonstrates the high efficacy of a single local administration of MSCs for PFCD compared with placebo (OR = 2.10, CI 1.28–3.46, p = 0.003). The most common postoperative complications — abscesses and fistulas — are probably associated with the natural course of the disease and do not differ significantly between the groups. The results of surgery may be affected by the type, source and concentration of MSCs, the method of delivery and the number of injections.   CONCLUSION: local administration of mesenchymal stem cells is an effective and safe method for perianal fistulas in Crohn’s disease, however, the presence of significant limitations in the meta-analysis makes it cautious about the results obtained and requires further randomized trials.