Meta-analysis of mNGF therapy for peripheral nerve injury: a systematic review

Objective: To assess the efficacy and safety of mouse nerve growth factor (mNGF) in patients with peripheral nerve injury. Methods: Such electronic database as Cochrane Library (Issue 1, 2011), Medline (1950-2011), Embase (1980-2011), National Knowledge Infrastructure (1979-2011) were searched and meanwhile relevant journals such as Chinese Journal of Orthopaedics, Chinese Journal of Microsurgery, Chinese Journal of Neurosurgery, etc were searched as well to collect all randomized controlled trials and quasi-randomized controlled trials of mNGF on patients with peripheral nerve injury. The quality of included studies was assessed according to the criteria recommended by the Cochrane Handbook for Systematic Reviews of Interventions and the data were extracted by two reviewers independently. Meta-analysis was conducted by RevMan 5.1 software. Results: Forty-one studies involving 3 304 patients with peripheral nerve injury were included. The results of meta-analysis showed that: (1) the total effective rate of peripheral nerve injury treatment in mNGF group was obviously higher than that in control group (OR=6.36, 95% CI 4.96-8.15, P<0.01); (2) the scores of activities of daily living (ADL) in mNGF group was significantly higher than that in control group (weighted mean difference=1.97, 95% CI 1.33-2.61, P<0.01); (3) the incidence of adverse reaction in mNGF group was higher than that in control group, (OR=1.66, 95% CI 1.61-2.38, P=0.006), but the adverse effects were mild, which could be relieved without specific treatment or just given symptomatic treatment, and disappeared at the end of treatment. Conclusions: The mNGF therapy is effective for peripheral nerve injury. It can obviously improve patient's ADL. Though the incidence of adverse reaction in mNGF treatment group is higher than that in control group, this does not influence the treatment outcomes.