Granulocyte-macrophage colony-stimulating factor for the treatment of peripheral arterial disease: A systematic review and meta-analysis
, 2, 3, 1, 4, 2
Abstract
Introduction: Peripheral arterial disease (PAD) affects approximately 200 million people globally, leading to
symptoms ranging from intermittent claudication to severe complications like critical limb ischaemia and amputation,
with a high associated mortality rate. Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF) has
shown promise in experimental models for promoting collateral arterial growth, and several randomized clinical
trials are exploring its efficacy in treating PAD. This meta-analysis aims to evaluate GM-CSF’s effectiveness
and safety in improving blood flow, reflected as an improvement in maximum walking time, providing further
insight into it as a potential novel treatment for PAD.
Materials and methods: This is a systematic review and meta-analysis following PRISMA (Preferred Reporting
Items for Systematic Reviews and Meta-Analyses) and Cochrane guidelines, using PubMed, Scopus, and
Cochrane databases. The focus was on randomized controlled trials comparing GM-CSF to placebo in patients
with peripheral arterial disease. Data on total walking time and safety outcomes were extracted for analysis.
Results: The meta-analysis showed no significant improvement in maximum walking time with GM-CSF
compared to placebo (pooled effect size 26.26, 95% CI [–36.93 to 89.44], P = 0.42) and demonstrated
homogeneity among the studies (Chi-square P = 0.61, I-square = 0%).
Conclusions: Based on the present findings, GM-CSF does not demonstrate significant efficacy in improving
walking distance among patients with peripheral arterial disease. Consequently, this study does not support
recommending GM-CSF for this purpose.
Keywords: granulocyte-macrophage colony-stimulating factorGM-CSFperipheral arterial diseaseclaudication
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