Adolopment of guideline on diabetic foot ulcers: an umbrella review with de novo meta-analyses of randomized controlled trials for autologous cell therapy in no-option chronic limb-threatening ischemia

KANTOROVÁ, Lucia, Tereza VRBOVÁ, Andrea POKORNÁ, Jitka KLUGAROVÁ and Miloslav KLUGAR. Adolopment of guideline on diabetic foot ulcers: an umbrella review with de novo meta-analyses of randomized controlled trials for autologous cell therapy in no-option chronic limb-threatening ischemia. In GIN Conference 2021. 2021.

Basic information

• Original name: Adolopment of guideline on diabetic foot ulcers: an umbrella review with de novo meta-analyses of randomized controlled trials for autologous cell therapy in no-option chronic limb-threatening ischemia
• Authors: KANTOROVÁ, Lucia (703 Slovakia, belonging to the institution), Tereza VRBOVÁ (203 Czech Republic, belonging to the institution), Andrea POKORNÁ (203 Czech Republic, belonging to the institution), Jitka KLUGAROVÁ (203 Czech Republic, belonging to the institution) and Miloslav KLUGAR (203 Czech Republic, belonging to the institution).
• Edition: GIN Conference 2021, 2021.

Other information

• Original language: English
• Type of outcome: Presentations at conferences
• Field of Study: 30202 Endocrinology and metabolism
• Country of publisher: Czech Republic
• Confidentiality degree: is not subject to a state or trade secret
• RIV identification code: RIV/00216224:14110/21:00122796
• Organization unit: Faculty of Medicine
• Keywords in English: diabetic foot ulcers; autologous cell therapy; umbrella review

Abstract

Background One of the approved guidelines by the Czech Health Research Council in the Project Clinical Practice Guidelines is focused on the issue of Diabetic foot ulcers (DFU). We identified several existing high-quality guidelines for adaptation; however, none addressed the question of proper use of autologous cell therapy (ACT) optimally. Objective This work presents methods and results of an umbrella systematic review following the JBI methodology to evaluate the effectiveness and safety of ACT in no-option critical limb-threatening ischemia (CLTI) for the DFU guideline adolopment process. Methods To keep up with the highest methodological standards and choose a feasible solution, we first searched 12 electronic sources via Epistemonikos in January 2021. We identified 19 systematic reviews (SR) of various quality and conflicting findings. We used the PRISMA guidelines and an a priori published protocol. To get conclusive answers, we decided to extract primary study results from the eligible SRs and undertake de novo meta-analyses, with detailed sensitivity and subgroup analyses, as discussed with clinical experts. We carried out a GRADE assessment of the certainty of evidence. Results We found 20 RCTs with 1140 participants in the SRs to be eligible for this review and the guideline under preparation. We assessed mortality, healed ulcers, major amputations, amputation-free survival, rest pain, and ischemic parameters. Discussion ACT likely improves healing, reduces amputations, alleviates pain, and may lead to a slight increase in the ankle-brachial index and transcutaneous oxygen pressure in CLTI patients.

Links

• MUNI/IGA/1068/2020, interní kód MU: Name: Methodological and practical aspects of the development of guidelines and rapid guidelines in public health (Acronym: RAPguidelines-public-health)

Investor: Masaryk University