Reassessing Stem Cell Therapy for Ischemic Stroke: A Systematic Review and Meta-analysis of Safety and Efficacy
Hesham Kelani1, Shrouk Mohamed2, Ahmed Elsary2, Asmaa Elganady2, Marina Ramzy Mourid2, Belal Shehata2, Mahmoud Abdelnasser2, Hazem Beshara2, Emina Dzafic3, Ahmed Elsherief4, Ahmed Naeem4
1Department of Neurology, SUNY Downstate Health Science UniversityAt One Brooklyn Health, 2Alexandria Faculty of Medicine, Alexandria, Egypt, 3Touro college of Osteopathic Medicine, 4Al-Azhar Faculty of Medicine, Egypt
Objective:
This meta-analysis evaluates the efficacy and safety of stem cell therapy in ischemic stroke, assessing its impact on neurological recovery and functional outcomes
Background:
Conventional stroke therapies such as thrombolysis and thrombectomy are effective, but they have several limitations. Stem cell therapy is a promising treatment modality that has demonstrated potential in neuroprotection, neuroregeneration, and functional recovery.
Design/Methods:
We searched the databases of PubMed, Scopus, Web of Science, and Cochrane Central from inception till 2024 to retrieve the related papers. Eligible studies included randomized controlled trials (RCTs), non-randomized clinical studies (non-RCTs), and Cohorts that investigated the use of stem cell therapy in patients with ischemic stroke. Data about the modified Rankin scale (mRS), National Institutes of Health Stroke Scale (NIHSS), Barthel index (BI), serious adverse events (SAEs), and mortality, were extracted. Stata software was used to analyze extracted data
Results:
Twenty-six studies including 1140 participants, were analyzed. Pooled results showed that, compared to the control group, stem cell therapy significantly decreased mRS scores (MD, ‐0.34; 95%CI [‐0.51, ‐0.17], P=0.00), decreased NIHSS scores (MD, ‐1.77; 95%CI [‐2.28, -1.25]; P=0.00) and increased BI (MD, 6.20; 95%CI [3.46, 8.94], P=0.00). No significant differences were found concerning SAEs and mortality (P=0.52 and P=0.80, respectively).
Conclusions:
Our meta-analysis shows that stem cell therapy improves functional outcomes in ischemic stroke patients by reducing mRS and NIHSS scores, increasing BI scores, and without increased risk of adverse events or mortality. Further large-scale trials are needed to confirm its long-term efficacy and safety.
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