Stem Cells for Stroke – Still a Long Way Off

The Lancet recently reported the results of stem cell therapy given six months or more after a hemiplegic stroke in eleven subjects.[1] A small degree of functional improvement was noted but in the absence of contemporaneous controls no firm cause and effect conclusion is possible – no dramatic effect here, such that such controls are not needed. An interesting question concerns the design of a proper trial – should the controls undergo a sham procedure? I am opposed to sham surgery trials involving more than minimal risk of harm for reasons spelled out elsewhere.[2] In the meantime, acute embolectomy is a highly effective treatment and the NHS needs to urgently reconfigure services to accommodate this new technology, as argued previously.[3] [4]

— Richard Lilford, CLAHRC WM Director

References:

  1. Borlongan CV. Age of PISCES: stem-cell clinical trials in stroke. Lancet. 2016; 388: 736-8.
  2. Wolf BR & Buckwalter JA. Randomized Surgical Trials and “Sham” Surgery: Relevance to Modern Orthopaedics and Minimally Invasive Surgery. Iowa Orthop J. 2006; 26: 107-11.
  3. Lilford RJ. Meta-analysis of emergency embolectomy for acute thrombotic stroke. NIHR CLAHRC West Midlands News Blog. September 2, 2016.
  4. Lilford RJ. First the heart, now the brain. NIHR CLAHRC West Midlands News Blog. April 10, 2015.
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