{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:39:16Z","timestamp":1790051956313,"version":"4.0.1"},"reference-count":62,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T00:00:00Z","timestamp":1685923200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002129","name":"Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002129","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This study examined the relative efficacy of growth factor therapies in healing diabetes\u2010related foot ulcers (DFU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed and Cochrane databases were searched for randomized controlled trials testing growth factor therapies for treating DFU. The primary outcome was complete wound closure. Results were reported as relative risk (RR)\u00a0\u00b1\u00a095% credible intervals (CrI). The risk of bias was assessed using Cochrane's RoB\u20102 tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 31 RCTs involving 2174 participants were included. Only 13 of the trials (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0924) reported on the aetiology of the ulcers (85.4% neuropathic and 14.6% ischaemic). Epidermal growth factor (RR 3.83; 95% CrI 1.81, 9.10), plasma\u2010rich protein (PRP) (RR 3.36; 95% CrI 1.66, 8.03) and platelet\u2010derived growth factor (PDGF) (RR 2.47; 95% CrI 1.23, 5.17) significantly improved the likelihood of complete ulcer healing compared to control. Sub\u2010analyses suggested that PRP (3 trials \u2010 RR 9.69; 95% CrI 1.37, 103.37) and PDGF (6 trials \u2010 RR 2.22; 95% CrI 1.12, 5.19) significantly improved the likelihood of wound closure amongst trial mainly recruiting participants with neuropathic ulcers. Eleven trials had a low risk of bias, 9 had some concerns and 11 had a high risk of bias. Sub\u2010analysis of trials with a low risk of bias suggested that none of the growth factors significantly improved ulcer healing compared with control.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This network meta\u2010analysis found low\u2010quality evidence that Epidermal growth factor, PRP and PDGF therapy improved DFU healing likelihood compared with control. Larger well\u2010designed trials are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dmrr.3670","type":"journal-article","created":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T21:10:17Z","timestamp":1686172217000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Comparative efficacy of growth factor therapy in healing diabetes\u2010related foot ulcers: A network meta\u2010analysis of randomized controlled trials"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0322-6147","authenticated-orcid":false,"given":"Shivshankar","family":"Thanigaimani","sequence":"first","affiliation":[{"name":"Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry James Cook University  Townsville Queensland Australia"},{"name":"The Australian Institute of Tropical Health and Medicine James Cook University  Townsville Queensland 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