Diversity around the effects of platelet-rich plasma for medical conditions

Article type
Authors
Latorraca CO1, Pachito DV2, Pacheco R3, Martimbianco AL4, Riera R5
1Universidade Federal de São Paulo (Unifesp)
2Centre of Health Technology Assessment, Hospital Sírio-Libanês
3Centro Universitário São Camilo (CUSC)
4Universidade Metropolitana de Santos (UNIMES) / Centro Universitário São Camilo(CUSC)
5Centre of Health Technology Assessment, Hospital Sírio-Libanês / Universidade Federal de São Paulo (Unifesp) / Cochrane Brazil
Abstract
Background: Considering the current use of platelet-rich plasma (PRP) for a wide range of medical conditions, the assessment of its clinical effects by a evidence-based approach is crucial.

Objectives:To provide a comprehensive synthesis of findings derived from systematic reviews (SRs) assessing effectiveness and safety of PRP.

Methods: Review of SRs Search strategies were applied in MEDLINE, Embase, Cochrane Library and LILACS in July 2018 to identify SRs of randomized controlled trials (RCTs) focusing on PRP for all types of non-transfusion use. Two authors independently screened all retrieved references in two stages (titles and abstracts at a first stage and full texts at a second stage). SRs were considered eligible if only RCTs were included. The methodological quality of the included SRs was appraised in accordance to AMSTAR 2. Conclusions were based on the most recent SRs with the highest quality

Results: 1,240 references were retrieved. After scrutinized against the inclusion criteria, 29 SRs of RCTs related to three different fields (wound care, orthopedics and dentistry) were included. We found results suggesting some benefit of PRP for diabetic wounds, acute and chronic lesions of musculoskeletal system, allogenic bone graft for dental implants, and periodontal intrabony defects.

Conclusions:There is a diversity on the certainty of evidence (ranging from low to moderate) supporting the use of PRP in specific clinical situations. The low quality of the evidence limits the certainty of these findings. Despite the increasing use of PRP, both in clinical practice and in research projects, uncertainties remain about PRP effects.

Patient or healthcare consumer involvement:Platelet-rich plasma (PRP) has been used in clinical pratice for a diversity of diseases. To identify the evidence for suportting each one of these indications is crucial for decision making.

All authors declare support from PROADI-SUS, Brazilian Ministry of Health and Hospital Sírio-Libanês for developing this study.