Entering the era of living biopharmaceuticals for treating knee osteoarthritis: A systematic review and network meta-analysis

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background Knee osteoarthritis (KOA) is a leading cause of arthritis-related morbidity. Mesenchymal stem cells (MSCs), as living biopharmaceuticals, have emerged as a potential treatment option due to their anti-inflammatory and immunomodulatory properties. Aim To compare the safety and efficacy of allogenic MSCs ( Allo MSCs) vs autologous MSCs ( Auto MSCs) in treating KOA in clinical settings. Methods We conducted a systematic review and network meta-analysis to compare the safety and efficacy of Allo MSCs vs Auto MSCs in treating KOA. Our systematic search of four databases, including PubMed, Cochrane, Embase, and ClinicalTrials.gov, identified relevant randomized controlled trials (RCTs) reporting MSC-based treatment for KOA and reporting visual analog scale, Western Ontario and McMaster Universities Osteoarthritis scores, and adverse events. We assessed the methodological quality of the studies using the Cochrane Collaboration tool and calculated risk ratios (RRs) and weighted mean differences [with 95% confidence intervals (CIs)]. Our statistical analyses used the R-Studio network meta-packages (version 2023.12.0). The study protocol was pre-registered on the International Prospective Register of Systematic Reviews (ID: CRD42024590866). Results Nineteen RCTs involving 1216 patients with KOA met the inclusion criteria of the study. The network meta-analysis showed that Allo

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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