Objective  To assess the safety and efficacy of recombinant human platelet-derived growth factor (rhPDGF) in adjuvant treatment of diabetes-related foot ulcer (DFU).

Methods  Randomized controlled trials (RCTs) on rhPDGF as an adjuvant treatment for DFU were systematically searched in PubMed, Embase, the Cochrane Library, CNKI, SinoMed, VIP, and WanFang Data from the establishment of databases to June 28, 2024. Data extraction and methodological quality evaluation were conducted on the included studies. RevMan 5.3 and R 4.3.1 softwares were used for Meta-analysis. Sensitivity analysis was performed by excluding moderate-low quality studies and leave-one-out method, and a funnel plot was constructed to detect the risk of publication bias.

Results  14 RCTs were included, involving a total of 1 388 DFU patients. The results indicated that compared with the standard of care, the rhPDGF adjuvant treatment could increase the wound healing rate of DFU [overall: OR=1.70, 95%CI(1.33-2.18), P<0.001; 5-12 weeks: OR=2.32, 95%CI(1.36-3.93), P=0.002; 13-24 weeks: OR=1.57, 95%CI(1.20-2.06), P=0.001; neuropathic: OR=1.81, 95%CI(1.36-2.41), P<0.001; non-infectious: OR=1.70, 95%CI(1.30-2.22), P<0.001]. However, there were no significant statistical differences in wound healing time, wound area reduction, and complication rate (P>0.05). The combined results after excluding low-quality studies also showed that rhPDGF adjuvant treatment could increase the wound healing rate of DFU [OR=1.68, 95%CI(1.27-2.23), P<0.001], and the results of sensitivity analysis by leave-out-one method were not significantly changed. The funnel plot demonstrated that there was a low probability of publication bias in this study.

Conclusion  rhPDGF adjuvant treatment of DFU can increase the wound healing rate without increasing the complication rate. Limited by research quality and other factors, the above conclusions still need to be confirmed by more high-quality RCTs.

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