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Comprehensive narrative review on the analysis of outcomes from cell transplantation clinical trials for discogenic low back pain
Intervertebral disc (IVD) degeneration is one of the primary causes of low back pain (LBP) and despite a prominent prevalence, present treatment options remain inadequate for a large portion of LBP patients. New developments in regenerative therapeutics offer potentially powerful medical tools to mo...
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Published in: | North American Spine Society journal (NASSJ) 2023-03, Vol.13, p.100195, Article 100195 |
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description | Intervertebral disc (IVD) degeneration is one of the primary causes of low back pain (LBP) and despite a prominent prevalence, present treatment options remain inadequate for a large portion of LBP patients. New developments in regenerative therapeutics offer potentially powerful medical tools to modify this pathology, with specific focus on (stem) cell transplantations. Multiple clinical trials have since reported overall beneficial outcomes favoring cell therapy. Nonetheless, the significance of these improvements is often not (clearly) discussed. As such, this narrative review aims to summarize the significance of the reported improvements from human clinical trials on IVD-targeted cell therapy.
Through a comprehensive narrative review we discuss the improvements in pain, disability, quality of life, and imaging modalities and reported adverse events following cell therapy for discogenic pain.
Most clinical trials were able to report clear and significant improvements in pain and disability outcomes. Imaging and quality of life improvements however were not as clearly reported but did present some enhancements for a select number of patients. Finally, whether cell therapy can outperform placebo treatment remains intangible.
Our review highlights the clinical significance of observed trends in pain and disability improvement. Nevertheless, reporting quality was found unsatisfactory and large-scale randomized controlled studies remain small in number. Future studies and articles should put more emphasis on improvements in imaging modalities and compare outcomes to (placebo) control groups to fully elucidate the efficacy and safety of cellular therapeutics against LBP. |
doi_str_mv | 10.1016/j.xnsj.2022.100195 |
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Through a comprehensive narrative review we discuss the improvements in pain, disability, quality of life, and imaging modalities and reported adverse events following cell therapy for discogenic pain.
Most clinical trials were able to report clear and significant improvements in pain and disability outcomes. Imaging and quality of life improvements however were not as clearly reported but did present some enhancements for a select number of patients. Finally, whether cell therapy can outperform placebo treatment remains intangible.
Our review highlights the clinical significance of observed trends in pain and disability improvement. Nevertheless, reporting quality was found unsatisfactory and large-scale randomized controlled studies remain small in number. Future studies and articles should put more emphasis on improvements in imaging modalities and compare outcomes to (placebo) control groups to fully elucidate the efficacy and safety of cellular therapeutics against LBP.</description><identifier>ISSN: 2666-5484</identifier><identifier>EISSN: 2666-5484</identifier><identifier>DOI: 10.1016/j.xnsj.2022.100195</identifier><identifier>PMID: 36655116</identifier><language>eng</language><publisher>United States: Elsevier Ltd</publisher><subject>Advances in Spinal Regenerative Therapies ; Cell therapy ; Disc degeneration ; Disc herniation ; Intervertebral disc ; Low back pain ; Mesenchymal stromal cells ; Regenerative medicine ; Spine ; Stem cells</subject><ispartof>North American Spine Society journal (NASSJ), 2023-03, Vol.13, p.100195, Article 100195</ispartof><rights>2022 The Author(s)</rights><rights>2022 The Author(s).</rights><rights>2022 The Author(s) 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c587t-53d9bcce21fadefd23c32e4597785230424a30aed8906b8b31f80163a0fad6933</citedby><cites>FETCH-LOGICAL-c587t-53d9bcce21fadefd23c32e4597785230424a30aed8906b8b31f80163a0fad6933</cites><orcidid>0000-0001-5489-2591</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9841054/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S2666548422000981$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,3549,27924,27925,45780,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36655116$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schol, Jordy</creatorcontrib><creatorcontrib>Sakai, Daisuke</creatorcontrib><title>Comprehensive narrative review on the analysis of outcomes from cell transplantation clinical trials for discogenic low back pain</title><title>North American Spine Society journal (NASSJ)</title><addtitle>N Am Spine Soc J</addtitle><description>Intervertebral disc (IVD) degeneration is one of the primary causes of low back pain (LBP) and despite a prominent prevalence, present treatment options remain inadequate for a large portion of LBP patients. New developments in regenerative therapeutics offer potentially powerful medical tools to modify this pathology, with specific focus on (stem) cell transplantations. Multiple clinical trials have since reported overall beneficial outcomes favoring cell therapy. Nonetheless, the significance of these improvements is often not (clearly) discussed. As such, this narrative review aims to summarize the significance of the reported improvements from human clinical trials on IVD-targeted cell therapy.
Through a comprehensive narrative review we discuss the improvements in pain, disability, quality of life, and imaging modalities and reported adverse events following cell therapy for discogenic pain.
Most clinical trials were able to report clear and significant improvements in pain and disability outcomes. Imaging and quality of life improvements however were not as clearly reported but did present some enhancements for a select number of patients. Finally, whether cell therapy can outperform placebo treatment remains intangible.
Our review highlights the clinical significance of observed trends in pain and disability improvement. Nevertheless, reporting quality was found unsatisfactory and large-scale randomized controlled studies remain small in number. Future studies and articles should put more emphasis on improvements in imaging modalities and compare outcomes to (placebo) control groups to fully elucidate the efficacy and safety of cellular therapeutics against LBP.</description><subject>Advances in Spinal Regenerative Therapies</subject><subject>Cell therapy</subject><subject>Disc degeneration</subject><subject>Disc herniation</subject><subject>Intervertebral disc</subject><subject>Low back pain</subject><subject>Mesenchymal stromal cells</subject><subject>Regenerative medicine</subject><subject>Spine</subject><subject>Stem cells</subject><issn>2666-5484</issn><issn>2666-5484</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNp9kk1v1DAQhiMEolXpH-CAfOSyiz9ix5EQElrxUakSFzhbE2ey65DYwc5u2yP_HIeUqr1w8mjmncfW67coXjO6ZZSpd_321qd-yynnuUFZLZ8V51wptZGlLp8_qs-Ky5R6SinXVNeMvSzOhFJSMqbOi9-7ME4RD-iTOyHxECPMSxXx5PCGBE_mAxLwMNwll0joSDjONoyYSBfDSCwOA5kj-DQN4Oe8nFfs4LyzsAwcDFkZImldsmGPuU-GcEMasD_JBM6_Kl50WYOX9-dF8ePzp--7r5vrb1-udh-vN1bqat5I0daNtchZBy12LRdWcCxlXVVackFLXoKggK2uqWp0I1ins08CaNarWoiL4mrltgF6M0U3QrwzAZz52whxbyDOzg5oLG8rIXXLMrKUugHUooFOAhes7Ooysz6srOnYjNha9NmB4Qn06cS7g9mHk6l1yahcAG_vATH8OmKazZjtyVaCx3BMhleqYhVVWmUpX6U2hpQidg_XMGqWKJjeLFEwSxTMGoW89ObxAx9W_n18FrxfBZgtzz8dTbIOvcXWRbRz9sT9j_8HNnDIoA</recordid><startdate>20230301</startdate><enddate>20230301</enddate><creator>Schol, Jordy</creator><creator>Sakai, Daisuke</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-5489-2591</orcidid></search><sort><creationdate>20230301</creationdate><title>Comprehensive narrative review on the analysis of outcomes from cell transplantation clinical trials for discogenic low back pain</title><author>Schol, Jordy ; Sakai, Daisuke</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c587t-53d9bcce21fadefd23c32e4597785230424a30aed8906b8b31f80163a0fad6933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Advances in Spinal Regenerative Therapies</topic><topic>Cell therapy</topic><topic>Disc degeneration</topic><topic>Disc herniation</topic><topic>Intervertebral disc</topic><topic>Low back pain</topic><topic>Mesenchymal stromal cells</topic><topic>Regenerative medicine</topic><topic>Spine</topic><topic>Stem cells</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schol, Jordy</creatorcontrib><creatorcontrib>Sakai, Daisuke</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>North American Spine Society journal (NASSJ)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schol, Jordy</au><au>Sakai, Daisuke</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comprehensive narrative review on the analysis of outcomes from cell transplantation clinical trials for discogenic low back pain</atitle><jtitle>North American Spine Society journal (NASSJ)</jtitle><addtitle>N Am Spine Soc J</addtitle><date>2023-03-01</date><risdate>2023</risdate><volume>13</volume><spage>100195</spage><pages>100195-</pages><artnum>100195</artnum><issn>2666-5484</issn><eissn>2666-5484</eissn><abstract>Intervertebral disc (IVD) degeneration is one of the primary causes of low back pain (LBP) and despite a prominent prevalence, present treatment options remain inadequate for a large portion of LBP patients. New developments in regenerative therapeutics offer potentially powerful medical tools to modify this pathology, with specific focus on (stem) cell transplantations. Multiple clinical trials have since reported overall beneficial outcomes favoring cell therapy. Nonetheless, the significance of these improvements is often not (clearly) discussed. As such, this narrative review aims to summarize the significance of the reported improvements from human clinical trials on IVD-targeted cell therapy.
Through a comprehensive narrative review we discuss the improvements in pain, disability, quality of life, and imaging modalities and reported adverse events following cell therapy for discogenic pain.
Most clinical trials were able to report clear and significant improvements in pain and disability outcomes. Imaging and quality of life improvements however were not as clearly reported but did present some enhancements for a select number of patients. Finally, whether cell therapy can outperform placebo treatment remains intangible.
Our review highlights the clinical significance of observed trends in pain and disability improvement. Nevertheless, reporting quality was found unsatisfactory and large-scale randomized controlled studies remain small in number. Future studies and articles should put more emphasis on improvements in imaging modalities and compare outcomes to (placebo) control groups to fully elucidate the efficacy and safety of cellular therapeutics against LBP.</abstract><cop>United States</cop><pub>Elsevier Ltd</pub><pmid>36655116</pmid><doi>10.1016/j.xnsj.2022.100195</doi><orcidid>https://orcid.org/0000-0001-5489-2591</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Advances in Spinal Regenerative Therapies Cell therapy Disc degeneration Disc herniation Intervertebral disc Low back pain Mesenchymal stromal cells Regenerative medicine Spine Stem cells |
title | Comprehensive narrative review on the analysis of outcomes from cell transplantation clinical trials for discogenic low back pain |
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