Is Regen-D (platelet-derived growth factor) effective for wound care?

Regen-D (Platelet-Derived Growth Factor) for Wound Care

Regen-D (recombinant human epidermal growth factor) is not recommended for routine wound care as there is insufficient evidence to support its use over standard care for diabetic foot ulcers. 1

Current Guidelines on Growth Factors for Wound Healing

The International Working Group on the Diabetic Foot (IWGDF) provides clear guidance on the use of growth factors for wound healing:

• The 2023 IWGDF guidelines suggest not using growth factor therapy as an adjunct to standard care for wound healing in people with diabetic foot ulcers (Conditional recommendation; Low quality evidence) 1
• The 2016 IWGDF guidance specifically noted that studies of recombinant platelet-derived growth factors showed either no improvement in healing between intervention and control groups or had significant methodological problems 1
• Multiple RCTs evaluating growth factors failed to demonstrate consistent benefits that would justify their routine use 1

Evidence on Regen-D Specifically

While some research studies have reported positive outcomes with Regen-D:

• A 2007 post-marketing surveillance study claimed enhanced healing of diabetic foot ulcers with Regen-D 150, reporting average wound healing time of 4.8 weeks compared to 9 weeks in Phase III clinical trials 2
• A 2020 hospital-based randomized controlled trial reported complete healing in 78% of subjects treated with Regen-D compared to 52% in the control group, with significantly shorter healing time (45±12 vs 72±18 days) 3

However, these studies have limitations:

• Small sample sizes (only 50 participants in the 2020 study)
• Methodological concerns including potential bias
• Limited follow-up periods
• Lack of cost-effectiveness analysis

Decision Algorithm for Wound Care

1. First-line approach: Implement standard wound care including:

   • Appropriate debridement
   • Infection control
   • Pressure offloading
   • Moisture balance
   • Vascular assessment and optimization

2. For non-healing wounds:

   • Consider negative pressure wound therapy for post-surgical wounds only 1
   • Consider autologous leucocyte, platelet, and fibrin patch for diabetic foot ulcers that have failed standard care (if resources exist) 1
   • Consider placental-derived products as an adjunct therapy where standard care has failed 1

3. Growth factors including Regen-D should not be considered as routine adjunctive therapy due to:

   • Inconsistent evidence of efficacy
   • Lack of cost-effectiveness data
   • Strong recommendations against their use in current guidelines

Common Pitfalls to Avoid

• Overreliance on novel therapies: Despite marketing claims, growth factors like Regen-D lack sufficient high-quality evidence to support routine use
• Cost concerns: These products are expensive, and cost-effectiveness has not been established 1
• Neglecting fundamentals: Focus on optimizing standard care before considering advanced therapies
• Inappropriate patient selection: Studies showing benefits often used very specific inclusion criteria that may not apply to most patients

Conclusion

While some individual studies suggest potential benefits of Regen-D for wound healing, current guidelines from IWGDF strongly recommend against using growth factors as routine adjunctive therapy for diabetic foot ulcers. Standard wound care remains the cornerstone of treatment, with consideration of specific advanced therapies only when standard care has failed and where strong evidence supports their use.