Extracorporeal Shockwave Therapy Effective in Treating Diabetic Foot Ulcers, reports study
A recent meta-analysis published in the Diabetes Research and Clinical Practice unveiled the effectiveness of extracorporeal shockwave therapy (ESWT) in treating diabetic foot ulcers (DFUs). The study reviewed randomized controlled trials (RCTs) published before August 8, 2023 and highlighted the potential benefits of ESWT as a therapeutic option for DFUs.
This research was carried out with extensive search of databases, including PubMed, EMBASE, Cochrane Controlled Register of Trials (CENTRAL), and Web of Science, to identify RCTs that investigated the efficacy and safety of ESWT for DFUs. A total of 10 trials met the selection criteria and were analyzed using STATA 14.0 software to evaluate the overall effectiveness of the treatment.
The analysis revealed that ESWT had a significantly higher rate of completely healed ulcers when compared to the control groups, with a risk ratio (RR) of 1.57 and a 95% confidence interval (CI) of 1.26 to 1.95. This indicated that patients receiving ESWT were 57% more likely to undergo complete healing of their ulcers than the individuals receiving standard treatments.
In addition to improved healing rates, ESWT was associated with a lower rate of unchanged ulcers, with a risk ratio of 0.25 (95% CI: 0.14 to 0.42). This meant that the risk of DFUs remaining unchanged during the treatment period was significantly reduced for the individuals undergoing ESWT by demonstrating the potential of this therapy to prevent ulcer stagnation.
Further subgroup analysis found that ESWT outperformed both hyperbaric oxygen therapy (HOT) and the standard of care (SOC) which further supports its effectiveness as a superior treatment option. The patients who underwent ESWT also faced a significant increase in their transcutaneous partial oxygen pressure (TcPO2), with a mean difference of 1.71 (95% CI: 1.22 to 2.19, p < 0.001). This improvement in oxygenation of the ulcer site is crucial in promoting tissue healing and reducing the risk of infection which are two major concerns in DFU management.
When it comes to safety, the analysis showed no significant differences between ESWT and the control groups in terms of treatment-emergent adverse events (TEAEs). While the rate of ulcers that showed at least 50% improvement was higher in the ESWT group, the difference was not statistically significant. These findings suggest that ESWT is not only effective but also well-tolerated by patients, with a safety profile comparable to the existing treatments. Overall, this study illuminates the potential of ESWT to improve ulcer healing and overall patient outcomes which is a promising advancement in diabetic care.
Source:
Wu, F., Qi, Z., Pan, B., & Tao, R. (2024). Extracorporeal shock wave therapy (ESWT) favors healing of diabetic foot ulcers: A systematic review and meta-analysis. In Diabetes Research and Clinical Practice (p. 111843). Elsevier BV. https://doi.org/10.1016/j.diabres.2024.111843
