Disclosures: Christopher Frey, MD: Nothing to disclose

Objective: To characterize the effects of antiplatelet and anti-inflammatory medications and activating agents on the platelet function and growth factor production in platelet rich plasma (PRP).

Design: A systematic review of the literature for the impact of antiplatelet, anti-inflammatory, and anticoagulant drugs was performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (PRISMA). Evidence was sourced from the PubMed and Cochrane Library online databases. After objective quality scoring, data concerning changes in growth factors and/or mitogenesis, platelet activation, statistical significance, model type, activating factor, and type of medication were extracted and described.

Setting: Systematic review

Participants: Fifteen studies met the inclusion and exclusion criteria. The studies were conducted in human, fibroblast, and rat in vitro as well as human and dog in vivo subjects.

Interventions: This was a systematic review.

Main Outcome Measures: Categorical aggregation of results to quantifying studies supporting change or no change observed in PRP platelet function or growth factor and mitogenesis production with antiplatelet or anti-inflammatory medications.

Results: Roughly half of the studies found a decrease in PRP growth factors or mitogenesis with antiplatelet or anti-inflammatory medications. All three studies using collagen, both studies using ADP alone, and one study utilizing arachidonic acid for PRP activation found a decrease in growth factor concentration. Both studies assessing CaCl2 alone and four of five studies investigating thrombin alone as activating agents indicated no change in PRP growth factor or mitogenesis production.

Conclusions: The choice of activating agent used in PRP formulation appears to influence therapeutic activity of PRP in the setting of anti-inflammatory and antiplatelet use. Development of protocols using well-studied activating agents may allow future patients to retain the benefit of PRP therapy without discontinuation of their current symptom-modifying or potentially mortality-reducing antiplatelet and anti-inflammatory medications.

Level of Evidence: Level I

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/effects-of-antiplatelet-medications-on-platelet-rich-plasma-a-systematic-review/