EP.FRI.154 Could Antiangiogenic Drugs be the Solution to Tendon Injury? A Literature Review on the use of Antiangiogenic Drugs for Tendon Regeneration

Abstract Background Tendinopathy accounts for more than half of reported musculoskeletal injuries worldwide. The subsequent healing process results in a disorganised tendon structure secondary to neovascularisation, forming a bulky tendon with overall reduced strength. Current treatment options remain controversial as re-rupture rates following surgical intervention are high. It has been proposed that the use of anti-vascular endothelial growth factors could improve tendon healing. Methods This literature review employed a systematic approach. The search strategy incorporated an adjusted PICO format and PRISMA flow diagram. Search findings were critically appraised using the CASP tool checklist. Identified studies investigated the effect of injectable anti-angiogenic drugs on tendon healing. Results Three final studies were identified. Tempfer et al. showed a reduction in cross sectional tendon area in the intervention group (5.6mm²+1.8), comparatively to the control group (9.1mm² +2.0), and increased tendon strength in the intervention group (47.7N+6.41) comparatively to the control group(32.41N+9.23). Dallaudiere (2014) et al. showed reduced cross-sectional area in the intervention group (0.95mm²+0.01) compared with the control group (0.75mm²+0.01). Dallaudiere (2013) et al. also showed reduced cross sectional areas in the intervention group (1.10mm²+0.01) compared with the control group (1.11mm²+0.03). Conclusion All studies supported the use of anti-angiogenic drugs to support tendon healing. The use of injectable anti-angiogenic drugs may potentially serve in conjunction with surgical intervention or as an alternative minimally invasive intervention to improve tendon rehabilitation. This review recommends that further randomised control studies will be needed to strengthen the current evidence.