Wolf, S. and Stanak, M. (2018): Allogeneic mesenchymal stem cells for Crohn’s disease-associated complex perianal fistulas. Decision Support Document 111.
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Standard treatments for Crohn’s disease (CD)-associated complex perianal fistulas result in high recurrence rates. We reviewed current evidence on efficacy and safety of allogeneic mesenchymal stem cells (MSCs) as an add-on therapy in refractory patients, compared to placebo therapy, fibrin glue or fistula plugs.
Two randomised controlled trials (RCTs), comparing MSCs with placebo, and one single-arm study were evaluated. Current evidence suggested that MSC-therapies lead to slight improvements of combined remission, though results for quality of life are inconclusive. It remains unclear if MSCs are safer than placebo procedures. The overall body of evidence was rated with very low evidence. RCTs comparing MSCs with therapies other than placebo, as well as long-term evidence, were lacking.
At present, we do not recommend the inclusion of MSCs as an add-on therapy in refractory CD-patients with complex perianal fistulas in the Austrian catalogue of benefits and suggest a reevaluation in 2022.
|Item Type:||Decision Support Document|
|Keywords:||Crohn’s disease, complex perianal fistulas, mesenchymal stem cells, systematic review|
|Subjects:||WB Practice of medicine > WB 300-962 Therapeutics|
W Health professions > W 100-275 Medical, dental and pharmaceutical service plans
WI Digestive system > WI 600-650 Anus. Rectum
WI Digestive system > WI 400-560 Intestines
QU Biochemistry > QU 300-375 Cells
WO Surgery > WO 660-690 Transplantation
|Series Name:||Decision Support Document 111|
|Deposited on:||20 Jul 2018 11:46|
|Last Modified:||20 Jul 2018 11:46|
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