Off label Use of PRP and ABI

Off label Use of PRP and ABI

Dr KK Aggarwal

President CMAAO and Past National President IMA

Platelets have a role in variety of processes not related to haemostasis and these include dissemination of cancer metastasis, liver regeneration, inflammatory arthritis, and immunity against pathogens.

Platelets secretes granules, which contain large amounts of cytokines and growth factors.

Platelets contain so many growth factors within their granules that they can accelerate wound healing by injecting platelets suspended within plasma (Platelet-Rich Plasma).

There are widely reported anecdotes and testimonies about the merits of Platelet-Rich Plasma therapy.

Ultrasound-guided dry needling and injection of autologous blood or platelet-rich plasma (PRP) may theoretically stimulate a healing response in chronic tendinopathy.

Such trials are needed, particularly in patients with chronic tendinopathy who have failed standard conservative treatment involving eccentric or heavy load exercise.

Other blood-derived therapies include injection of autologous whole blood (ABI) and extracted blood derivatives. They are injected at the site of injury and are purported to deliver supraphysiologic concentrations of cytokines and other substances that promote growth and repair and mediate the inflammatory process.

PRP is also used for medical healing of perforated tympanic membrane.

An epidural blood patch is a surgical procedure that uses autologous blood in order to close one or many holes in the dura mater of the spinal cord, usually as a result of a previous lumbar puncture. The procedure can be used to relieve post Dural puncture headaches caused by lumbar puncture (spinal tap).

Also, ABI is used to treat refractory urticarias.

Both PRP and ABI describes a treatment without standardization of manufacturing methodology, administration schedules, or return-to-exercise guidelines. Use of these products require adherence to country specific off label policies.

ABI and PRP are not stem cell therapies. Indian Council of Medical Research (ICMR), is coming up with norms in January that will serve as guidelines for stem cell banks and research bodies.