PMID- 38477463
OWN - NLM
STAT- Publisher
LR  - 20240313
IS  - 1945-7197 (Electronic)
IS  - 0021-972X (Linking)
DP  - 2024 Mar 13
TI  - Improving Diabetic Wound Healing Outcomes with Topical Growth Factor Therapies: 
      Systematic Review and Network Meta-analysis of Randomised-controlled Trials.
LID - dgae128 [pii]
LID - 10.1210/clinem/dgae128 [doi]
AB  - CONTEXT: Diabetes mellitus is associated with morbid complications such as 
      diabetic foot ulcers (DFUs) that may lead to amputations or mortality if not 
      managed adequately. OBJECTIVE: New adjunctive interventions to treat diabetic 
      wounds include topical biologics and growth factors. This study aims to evaluate 
      their efficacy in improving wound healing outcomes and safety. DATA SOURCES: 
      Comprehensive database searches of MEDLINE via PubMed, EMBASE and Cochrane 
      performed from inception to December 2022. STUDY SELECTION: Three independent 
      researchers selected the studies. Randomised-controlled trials that compared the 
      use of a topical biologic growth factor-containing regimen to other biologics or 
      standard of care (SOC) were included. DATA EXTRACTION AND SYNTHESIS: This review 
      followed PRISMA guidelines. Risk of bias analysis was performed using the Jadad 
      scale. Network meta-analysis was performed. Treatments were grouped into common 
      nodes based on the type of biologic agent. MAIN OUTCOMES AND MEASURES: Primary 
      outcomes of interest were healing rate and time to wound closure. Secondary 
      outcomes included wound infection, serious adverse events, and amputation rate. 
      RESULTS: Human umbilical cord (HUC) was associated with the highest cure, 
      followed by recombinant human epidermal growth factor (hEGF). A significantly 
      greater reduction in the time to cure DFUs was seen in HUC, hEGF and fibroblast 
      growth factor (FGF). There was a significantly lower risk of adverse events (AEs) 
      when platelet-rich plasma (PRP) was administered. CONCLUSION: HUC, hEGF and FGF 
      are promising topical biologics with statistically significant primary outcomes 
      compared to SOC, while PRP is effective in reducing ulcer-related AEs. HUC has 
      been found to be the most effective in terms of cure rate and a reduction in time 
      to cure.
CI  - (c) The Author(s) 2024. Published by Oxford University Press on behalf of the 
      Endocrine Society. All rights reserved. For commercial re-use, please contact 
      reprints@oup.com for reprints and translation rights for reprints. All other 
      permissions can be obtained through our RightsLink service via the Permissions 
      link on the article page on our site-for further information please contact 
      journals.permissions@oup.com.
FAU - Wong, Andrew Yew Wei
AU  - Wong AYW
AUID- ORCID: 0009-0008-8667-0334
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
FAU - Hooi, Natalie Ming Foong
AU  - Hooi NMF
AD  - Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
FAU - Yeo, Brian Sheng Yep
AU  - Yeo BSY
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
FAU - Sultana, Rehena
AU  - Sultana R
AD  - Duke-NUS Medical School, National University of Singapore, Singapore.
FAU - Bee, Yong Mong
AU  - Bee YM
AD  - Department of Endocrinology, Singapore General Hospital, Singapore.
FAU - Lee, Ainsley Ryan Yan Bin
AU  - Lee ARYB
AUID- ORCID: 0000-0002-5896-2929
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
FAU - Tay, Sook Muay
AU  - Tay SM
AUID- ORCID: 0000-0001-8028-9470
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
AD  - Department of Surgical Intensive Care, Singapore General Hospital, Singapore.
LA  - eng
PT  - Journal Article
DEP - 20240313
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
SB  - IM
OTO - NOTNLM
OT  - Diabetes Complications
OT  - Diabetes mellitus
OT  - Diabetic foot
OT  - Diabetic neuropathies
OT  - Diabetic ulcers
OT  - Wound healing
EDAT- 2024/03/13 12:47
MHDA- 2024/03/13 12:47
CRDT- 2024/03/13 08:14
PHST- 2023/11/17 00:00 [received]
PHST- 2024/02/28 00:00 [revised]
PHST- 2024/02/29 00:00 [accepted]
PHST- 2024/03/13 12:47 [medline]
PHST- 2024/03/13 12:47 [pubmed]
PHST- 2024/03/13 08:14 [entrez]
AID - 7627888 [pii]
AID - 10.1210/clinem/dgae128 [doi]
PST - aheadofprint
SO  - J Clin Endocrinol Metab. 2024 Mar 13:dgae128. doi: 10.1210/clinem/dgae128.