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Growth factors like epidermal and platelet-derived types showed strong benefits in accelerating healing and reducing complications in DFUs.  

Researchers conducted a retrospective study published in June 2025 issue of Frontiers in Endocrinology to compare the efficacy and safety of various growth factors (GFs) in treating diabetic foot ulcers (DFUs) u`sing a network meta-analysis.  

They searched systematically in Embase, PubMed, The Cochrane Library, and Web of Science to determine randomized controlled trials (RCTs) comparing GFs with standard of care (SOC) or with other GFs for DFU treatment. Two independent reviewers screened studies, extracted data, and evaluated study quality based on predefined inclusion and exclusion criteria. A network meta-analysis was conducted by R software. Relative risk (RR) was applied for dichotomous outcomes, and mean difference (MD) was employed for continuous outcomes.  

The results showed that 51 RCTs involving 3,401 individuals with DFUs and 6 types of GFs were included. Compared with SOC, epidermal growth factor (EGF), platelet-derived growth factor (PDGF), and platelet-rich plasma (PRP) improved healing rates. The EGF and PRP also shortened healing time, while PDGF reduced ulcer area, PRP was linked to a lower incidence of adverse events (AEs) and amputation rates. In ranking: for healing rate, the top 3 GFs were EGF, granulocyte colony-stimulating factor (G-CSF) and vascular endothelial growth factor (VEGF); for healing time, EGF, PRP, and fibroblast growth factor (FGF); for ulcer area reduction, PDGF, EGF, and PRP; for AEs, PRP, PDGF, and FGF; and for amputation rate, PRP, G-CSF, and PDGF ranked highest.  

Investigators concluded that most GFs, particularly EGF, PDGF, and PRP, were more effective than SOC in improving healing outcomes in diabetic foot ulcers without increasing AEs.

Source: frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1614597/full