What is the safety and usage of PDRN (Polydeoxyribonucleotide) in medical treatments?

Safety and Usage of Polydeoxyribonucleotide (PDRN) in Medical Treatments

Based on current evidence, PDRN is not recommended for use in wound healing or other medical treatments over standard of care due to limited high-quality evidence supporting its efficacy and safety. 1

What is PDRN?

• PDRN (Polydeoxyribonucleotide) is a DNA derivative that has been investigated for its potential to promote tissue repair through various mechanisms 2
• It is composed of low molecular weight DNA molecules of natural origin that may stimulate cell migration and growth, extracellular matrix protein production, and reduce inflammation 3
• PDRN is believed to exert its effects primarily through activation of the adenosine A2A receptor 3

Clinical Applications and Evidence

Wound Healing

• The International Working Group on the Diabetic Foot (IWGDF) does not recommend PDRN for diabetic foot ulcers, classifying it among agents that alter wound biology without sufficient evidence to justify routine use 1
• A 2023 update from IWGDF specifically recommends against using pharmacological agents promoting perfusion and angiogenesis (including PDRN) to improve wound healing outcomes over standard care (Strong recommendation; Low quality evidence) 1
• While some small studies suggest PDRN may enhance wound healing in vitro and in animal models, the evidence is considered insufficient for clinical recommendation 2, 4

Dermatological Applications

• PDRN has shown potential in preventing hypertrophic scarring after surgery in a small randomized controlled trial 5
• Some research suggests PDRN may have anti-melanogenesis properties that could be beneficial for treating hyperpigmentation 6
• However, these applications lack robust clinical evidence and standardized protocols 3

Hair Restoration

• Limited evidence suggests that PDRN may improve hair thickness and density when used in combination with PRP (Platelet-Rich Plasma) for female pattern hair loss 1
• However, studies are small and lack standardized protocols for administration 1

Musculoskeletal Applications

• PDRN has been investigated for bone, cartilage, and tendon regeneration, but with significant variability in dosing and administration protocols 3
• Clinical evidence for these applications remains limited and of low quality 3

Safety Considerations

• The IWGDF notes that while PDRN shows small beneficial effects on wound healing, it has "trivial undesirable effects" though the level of certainty about these effects is very low 1
• No specific severe adverse effects have been documented in the available literature 5, 3
• Most studies report good tolerability, with the main side effect being pain at injection sites 5
• There is insufficient data on long-term safety and potential interactions with other medications 1

Practical Considerations

• PDRN administration typically involves multiple injections (3-5 sessions) 3
• The optimal dosage for musculoskeletal applications is not well established, unlike skin applications which have more standardized protocols 3
• Resource implications are moderate, potentially reducing equity in healthcare systems with limited resources 1
• The cost-effectiveness of PDRN treatments has not been adequately evaluated in clinical studies 1

Conclusion and Recommendations

• Current high-quality guidelines do not support the use of PDRN over standard care for wound healing 1
• While PDRN shows promise in several applications, the evidence base remains insufficient to recommend its routine use 1
• Healthcare providers should consider PDRN as an experimental treatment and comply with national legislation and ethical guidelines concerning investigational treatments 1
• Patients should be informed about the limited evidence supporting PDRN use and the availability of alternative treatments with stronger evidence bases 1