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Turner L, Martinez JR, Najjar S, Arachchilage TR, Sahrai V, Wang JC. Safety and efficacy claims made by US businesses marketing purported stem cell treatments and exosome therapies. Regen Med 2023; 18:781-793. [PMID: 37795701 DOI: 10.2217/rme-2023-0118] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
Aim: Examining websites of US businesses engaged in direct-to-consumer advertising of putative stem cell treatments and exosome therapies, this study investigated the marketing claims such companies make about the purported safety and efficacy of these products. Methods: Data mining and content analysis of company websites were used to identify and analyze safety and efficacy claims. Results: Of the 978 businesses analyzed, less than half the companies made identifiable claims about the safety and efficacy of their advertised stem cell and exosome products. We also explored how companies framed the stem cell and exosome products they promoted. Representations ranged from assertions that such products are unproven and investigational to claims they constituted cures. Most advertising frames fell between these poles. Conclusion: Some businesses include in their marketing representations claims about the safety and efficacy of advertised products. Businesses that did not make such assertions use other techniques to attract prospective clients.
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Affiliation(s)
- Leigh Turner
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Irvine, CA 92697-3957, USA
- Department of Health, Society, & Behavior, University of California, Irvine, CA 92697-3957, USA
- Sue & Bill Gross Stem Cell Research Center, University of California, Irvine, CA 92697, USA
| | - Juan Ramon Martinez
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Irvine, CA 92697-3957, USA
| | - Shemms Najjar
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Irvine, CA 92697-3957, USA
| | - Thevin Rajapaksha Arachchilage
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Irvine, CA 92697-3957, USA
| | - Victoria Sahrai
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Irvine, CA 92697-3957, USA
| | - Jia Chieng Wang
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Irvine, CA 92697-3957, USA
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Kim M, Knoepfler PS. Anticipated impact of stem cell and other cellular medicine clinical trials for COVID-19. Regen Med 2021; 16:525-533. [PMID: 34114493 PMCID: PMC8202509 DOI: 10.2217/rme-2021-0025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Aim: There is a critical need for safe and effective treatments for COVID-19. One possible type of treatment is cellular medicine such as stem cell therapy, but its potential is unclear. Here, our aim was to assess the potential impact of the many cellular medicine trials for COVID-19. Materials & methods: We collected and analyzed data for defined criteria from trial registries. Results: Our data suggest that relatively few of these COVID-19 trials will produce high-level evidence, but that on average they may be somewhat more rigorous than typical cell therapy trials unrelated to COVID-19. Conclusion: Most COVID-19 cellular medicine trials have relatively low potential for rapid, concrete impact. We discuss the findings in the context of the cellular medicine field overall.
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Affiliation(s)
- Mina Kim
- Department of Cell Biology & Human Anatomy, School of Medicine, University of California, Davis, 1 Shields Ave, Davis, CA 95616, USA
| | - Paul S Knoepfler
- Department of Cell Biology & Human Anatomy, School of Medicine, University of California, Davis, 1 Shields Ave, Davis, CA 95616, USA.,Institute for Pediatric Regenerative Medicine, Shriners Hospital for Children, 2425 Stockton Blvd., Sacramento, CA 95817, USA
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Julian K, Yuhasz N, Rai W, Salerno JA, Imitola J. Complications from “Stem Cell Tourism” in Neurology. Ann Neurol 2020; 88:661-668. [DOI: 10.1002/ana.25842] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 07/03/2020] [Accepted: 07/03/2020] [Indexed: 01/26/2023]
Affiliation(s)
- Katherine Julian
- Department of Neurology The Ohio State University Wexner Medical Center Columbus Ohio USA
- Laboratory for Neural Stem Cells and Functional Neurogenetics, Division of Multiple Sclerosis and Neuroimmunology, Department of Neurology UConn School of Medicine Farmington CT USA
| | - Nicholas Yuhasz
- Department of Neurology The Ohio State University Wexner Medical Center Columbus Ohio USA
| | - Widjan Rai
- Department of Neurology The Ohio State University Wexner Medical Center Columbus Ohio USA
| | - Jose A. Salerno
- Department of Neurology The Ohio State University Wexner Medical Center Columbus Ohio USA
- National Laboratory of Embryonic Stem Cells Universidad Federal Rio de Janeiro Brazil
| | - Jaime Imitola
- Department of Neurology The Ohio State University Wexner Medical Center Columbus Ohio USA
- Laboratory for Neural Stem Cells and Functional Neurogenetics, Division of Multiple Sclerosis and Neuroimmunology, Department of Neurology UConn School of Medicine Farmington CT USA
- UConn Health Comprehensive Multiple Sclerosis Center, Division of Multiple Sclerosis and Neuroimmunology, Department of Neurology UConn School of Medicine Farmington CT USA
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How to Peddle Hope: An Analysis of YouTube Patient Testimonials of Unproven Stem Cell Treatments. Stem Cell Reports 2020; 12:1186-1189. [PMID: 31189092 PMCID: PMC6565870 DOI: 10.1016/j.stemcr.2019.05.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 05/09/2019] [Accepted: 05/12/2019] [Indexed: 12/11/2022] Open
Abstract
Providers capitalize on patient testimonials to market unproven stem cell treatments (SCTs). We evaluated 159 YouTube videos and found patients discussed health improvements (91.2%), praised providers (53.5%), and recommended SCTs (28.9%). In over a third of the videos, providers posed questions to patients, thereby directing narratives and making them a powerful marketing tool.
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Taliaferro J, Shapiro SA, Montero DP, Shi GG, Wilke BK. Cash-Based Stem-Cell Clinics: The Modern Day Snake Oil Salesman? A Report of Two Cases of Patients Harmed by Intra-articular Stem Cell Injections. JBJS Case Connect 2019; 9:e0363. [PMID: 31815806 DOI: 10.2106/jbjs.cc.19.00363] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
CASE The use of biologics is rapidly expanding. Over the past decade, there has been a significant increase in the number of cash-based "stem cell"/regenerative medicine clinics in the United States. These clinics provide cash-based services touting stem cell injections to cure a myriad of conditions. Largely, these clinics are unregulated and using injections in a non-Food and Drug Administration-approved manner. We report on 2 patients who presented with symptoms suggestive of septic arthritis following stem cell injections by cash-based local stem cell clinics. Case 1 involved a patient who developed septic arthritis following an injection of umbilical cord blood-derived cellular products (Genentech) and required an antibiotic spacer followed by a total hip arthroplasty. Case 2 involved a patient who developed a likely immune-mediated reaction following an injection of morselized human placental allograft tissue by a local chiropractic office at a cost of approximately $8,000. CONCLUSIONS We present these cases to bring increased awareness to the issue and call for increased regulation of this practice.
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Affiliation(s)
- John Taliaferro
- Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida
| | - Shane A Shapiro
- Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida
| | - Daniel P Montero
- Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida
| | - Glenn G Shi
- Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida
| | - Benjamin K Wilke
- Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida
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Knoepfler PS. Rapid change of a cohort of 570 unproven stem cell clinics in the USA over 3 years. Regen Med 2019; 14:735-740. [PMID: 31456478 DOI: 10.2217/rme-2019-0064] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Aim: The industry of unproven stem cell clinics has rapidly mushroomed throughout the USA, posing risks to patients and the research field. In this study, the aim was to better define how this industry changes. Methods: I analyzed a large cohort of US stem cell clinic firms and their distinct clinic locations as defined in 2015-2016 for their status now in 2019. Results: About a quarter of the firms no longer marketed stem cells. Some lacked active websites, while others dropped stem cell services. Even so, the total number of clinics in this group increased because some firms greatly expanded their clinic numbers. Conclusion: Overall, the unproven clinic industry is a moving target requiring ongoing study and regulatory oversight.
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Affiliation(s)
- Paul S Knoepfler
- Department of Cell Biology & Human Anatomy, University of California Davis, Davis, CA 95616, USA.,Institute of Pediatric Regenerative Medicine, Shriners Hospital for Children Northern California, Sacramento, CA 95817, USA
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Caulfield T, Murdoch B. Regulatory and policy tools to address unproven stem cell interventions in Canada: the need for action. BMC Med Ethics 2019; 20:51. [PMID: 31383026 PMCID: PMC6683337 DOI: 10.1186/s12910-019-0388-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 07/08/2019] [Indexed: 01/02/2023] Open
Abstract
Background The marketing of unproven direct-to-consumer stem cell interventions is becoming widespread in Canada. There is little evidence supporting their use and they have been associated with a range of harms. Canada has been slower to act against clinics offering these interventions than other jurisdictions, including the United States. Here, we outline the regulatory and policy tools available in Canada to address this growing problem. Main body Health Canada’s regulations governing cell therapies are complex, but recent statements make it clear that Health Canada believes it has jurisdiction over many of the currently marketed stem cell interventions. Still, further regulatory clarity is needed from Health Canada, as are increased directed enforcement efforts on interventions that fall within their scope. The Competition Bureau, via the Competition Act, prohibits advertisers from making materially false or misleading promotional representations. The Competition Bureau could collaborate with the scientific community to analyze the claims of existing clinics in Canada, and impose sanctions upon those who breach the established standard. Professional regulators, including provincial colleges of physicians and surgeons, have considerable power over what products and services their members can offer. Every college of physicians in Canada requires, via policy and codes of ethics, that doctors maintain evidence-based practices. This requirement is incompatible with offering many unproven stem cell interventions. Litigation may be another tool, including the use of fraud, misrepresentation and/or negligence claims for failing to meet the required standard of care. Finally, political pressure on federal and provincial lawmakers could encourage changes to marketing, cell therapy and professional regulations that would allow a more comprehensive response. Conclusions In sum, there are many existing tools that can be used to protect the public from unproven stem cell interventions. Increased bureaucratic will and grassroots efforts are needed in order to effect a positive policy response.
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Affiliation(s)
- Timothy Caulfield
- Health Law Institute, Faculty of Law, University of Alberta, 468 Law Centre, Edmonton, Alberta, T6G 2H5, Canada.
| | - Blake Murdoch
- Health Law Institute, Faculty of Law, University of Alberta, 468 Law Centre, Edmonton, Alberta, T6G 2H5, Canada
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MacPherson A, Kimmelman J. Ethical development of stem-cell-based interventions. Nat Med 2019; 25:1037-1044. [PMID: 31270501 DOI: 10.1038/s41591-019-0511-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 06/04/2019] [Indexed: 02/07/2023]
Abstract
The process of developing new and complex stem-cell-based therapeutics is incremental and requires decades of sustained collaboration among different stakeholders. In this Perspective, we address key ethical and policy challenges confronting the clinical translation of stem-cell-based interventions (SCBIs), including premature diffusion of SCBIs to clinical practice, assessment of risk in trials, obtaining valid informed consent for research participants, balanced and complete scientific reporting and public communications, regulation, and equitable access to treatment. We propose a way forward for translating these therapies with the above challenges in mind.
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Affiliation(s)
- Amanda MacPherson
- Biomedical Ethics Unit, STREAM Research Group, McGill University, Montreal, Canada
| | - Jonathan Kimmelman
- Biomedical Ethics Unit, STREAM Research Group, McGill University, Montreal, Canada.
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Abstract
The stem cell and regenerative medicine arena has become increasingly complicated in recent years with thousands of people involved. There are as many as a dozen or more main groups of stakeholders, who together may be viewed as one ecosystem that is now rapidly evolving. The nature of the ecosystem and its evolution have major implications for not just those within it, but also for medicine and society at large. Here, I describe this ecosystem and its evolution, as well as the negative impacts within the ecosystem of a constellation of hundreds of unproven for-profit clinics and related businesses. Finally, I propose approaches for how to positively influence and drive the future of the global stem cell ecosystem.
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Affiliation(s)
- Paul S Knoepfler
- Department of Cell Biology & Human Anatomy, University of California, Davis, 1 Shields Ave, Davis, CA 95616, USA
- Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children Northern California, Sacramento, CA 95817, USA
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