Fracture Fusion on Fast‐Forward: Locally Administered Deferoxamine Significantly Enhances Fracture Healing in Animal Models: A Systematic Review and Meta‐Analysis

Abstract Fractures, with a yearly incidence of 1.2%, can lead to healing complications in up to 10% of cases. The angiogenic stimulant deferoxamine (DFO) is recognized for enhancing bone healing when administered into the fracture gap. This systematic review with meta‐analysis investigates the effec...

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Main Authors: Daniel Müller, Jens Klotsche, Magdalena B. Kosik, Carsten Perka, Frank Buttgereit, Paula Hoff, Timo Gaber
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:Advanced Science
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Online Access:https://doi.org/10.1002/advs.202413290
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author Daniel Müller
Jens Klotsche
Magdalena B. Kosik
Carsten Perka
Frank Buttgereit
Paula Hoff
Timo Gaber
author_facet Daniel Müller
Jens Klotsche
Magdalena B. Kosik
Carsten Perka
Frank Buttgereit
Paula Hoff
Timo Gaber
author_sort Daniel Müller
collection DOAJ
description Abstract Fractures, with a yearly incidence of 1.2%, can lead to healing complications in up to 10% of cases. The angiogenic stimulant deferoxamine (DFO) is recognized for enhancing bone healing when administered into the fracture gap. This systematic review with meta‐analysis investigates the effect of local DFO application on bone healing in rat and mouse models. EMBASE, MEDLINE (PubMed), and Web of Science are systematically searched in January 2024. The study is prospectively registered in PROSPERO (CRD42024492533), and the SYRCLE tool is used to assess study quality and risk of bias. Outcome values contain the primary endpoint bone volume fraction (BV/TV) as well as the secondary endpoints bone volume, tissue volume, bone mineral density, trabecular separation, trabecular thickness, vessel formation and the mechanical properties, assessed by µCT, angiography and mechanical strength tests. Out of 21 included studies, 18 qualify for meta‐analysis, involving 539 animals. DFO‐treated groups exhibit significantly higher BV/TV values (p < 0.0001) compared to controls, with similarly significant improvements in secondary outcomes. These findings highlight the substantial benefit of DFO in promoting bone healing, especially after radiotherapy. Rapid clinical implementation is recommended to help patients at high risk of fracture healing complications.
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spelling doaj-art-4cfb90e3d9fa4b5bb61e455908811b802025-08-20T03:49:36ZengWileyAdvanced Science2198-38442025-02-01128n/an/a10.1002/advs.202413290Fracture Fusion on Fast‐Forward: Locally Administered Deferoxamine Significantly Enhances Fracture Healing in Animal Models: A Systematic Review and Meta‐AnalysisDaniel Müller0Jens Klotsche1Magdalena B. Kosik2Carsten Perka3Frank Buttgereit4Paula Hoff5Timo Gaber6Department of Rheumatology and Clinical Immunology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin 10117 Berlin GermanyDeutsches Rheumaforschungszentrum Berlin (DRFZ) a Leibniz Institute 10117 Berlin GermanyDepartment of Rheumatology and Clinical Immunology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin 10117 Berlin GermanyCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin CharitéCenter for Orthopedics und Traumatology 10117 Berlin GermanyDepartment of Rheumatology and Clinical Immunology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin 10117 Berlin GermanyDepartment of Rheumatology and Clinical Immunology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin 10117 Berlin GermanyDepartment of Rheumatology and Clinical Immunology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin 10117 Berlin GermanyAbstract Fractures, with a yearly incidence of 1.2%, can lead to healing complications in up to 10% of cases. The angiogenic stimulant deferoxamine (DFO) is recognized for enhancing bone healing when administered into the fracture gap. This systematic review with meta‐analysis investigates the effect of local DFO application on bone healing in rat and mouse models. EMBASE, MEDLINE (PubMed), and Web of Science are systematically searched in January 2024. The study is prospectively registered in PROSPERO (CRD42024492533), and the SYRCLE tool is used to assess study quality and risk of bias. Outcome values contain the primary endpoint bone volume fraction (BV/TV) as well as the secondary endpoints bone volume, tissue volume, bone mineral density, trabecular separation, trabecular thickness, vessel formation and the mechanical properties, assessed by µCT, angiography and mechanical strength tests. Out of 21 included studies, 18 qualify for meta‐analysis, involving 539 animals. DFO‐treated groups exhibit significantly higher BV/TV values (p < 0.0001) compared to controls, with similarly significant improvements in secondary outcomes. These findings highlight the substantial benefit of DFO in promoting bone healing, especially after radiotherapy. Rapid clinical implementation is recommended to help patients at high risk of fracture healing complications.https://doi.org/10.1002/advs.202413290µCtbone regenerationdeferoxaminemouse modelrat model
spellingShingle Daniel Müller
Jens Klotsche
Magdalena B. Kosik
Carsten Perka
Frank Buttgereit
Paula Hoff
Timo Gaber
Fracture Fusion on Fast‐Forward: Locally Administered Deferoxamine Significantly Enhances Fracture Healing in Animal Models: A Systematic Review and Meta‐Analysis
Advanced Science
µCt
bone regeneration
deferoxamine
mouse model
rat model
title Fracture Fusion on Fast‐Forward: Locally Administered Deferoxamine Significantly Enhances Fracture Healing in Animal Models: A Systematic Review and Meta‐Analysis
title_full Fracture Fusion on Fast‐Forward: Locally Administered Deferoxamine Significantly Enhances Fracture Healing in Animal Models: A Systematic Review and Meta‐Analysis
title_fullStr Fracture Fusion on Fast‐Forward: Locally Administered Deferoxamine Significantly Enhances Fracture Healing in Animal Models: A Systematic Review and Meta‐Analysis
title_full_unstemmed Fracture Fusion on Fast‐Forward: Locally Administered Deferoxamine Significantly Enhances Fracture Healing in Animal Models: A Systematic Review and Meta‐Analysis
title_short Fracture Fusion on Fast‐Forward: Locally Administered Deferoxamine Significantly Enhances Fracture Healing in Animal Models: A Systematic Review and Meta‐Analysis
title_sort fracture fusion on fast forward locally administered deferoxamine significantly enhances fracture healing in animal models a systematic review and meta analysis
topic µCt
bone regeneration
deferoxamine
mouse model
rat model
url https://doi.org/10.1002/advs.202413290
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