Background/Objectives: Crohn’s disease (CD) is a chronic inflammatory disorder that significantly affects patients’ quality of life; conventional treatments often provide limited relief. Methods: This systematic review and meta-analysis explored the potential of regenerative therapies, particularly platelet-rich plasma (PRP), as an adjunctive treatment for CD. The study protocol was registered with PROSPERO (CRD42024576683), and a comprehensive search was conducted across major databases, such as PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. The search included terms related to CD and PRP. Studies assessing the efficacy of PRP in CD treatment were selected. Statistical analysis was conducted using the PICO framework with R software (version 4.3.2) and meta-package. Results: Of the 29 studies identified, 10 met the inclusion criteria, comprising pilot studies and controlled trials. Nine studies focused on Crohn’s disease perianal fistulas (CDPF), and one focused on colonic CD. Among 138 patients with CDPF, 82.44% showed some fistula healing after PRP treatment, with 48.05% achieving complete resolution. In a sub-analysis, combining PRP with a stromal vascular fraction (SVF) resulted in a 58.62% complete healing rate, whereas combining PRP with adipose-derived stem cells (ASCs) showed even higher efficacy at 85.89%. PRP treatment alone resulted in a lower complete healing rate of 38.51%. PRP was well tolerated, with minor side effects such as localized pain. Conclusions: These findings suggest that PRP, especially when combined with stem cells, offers a promising new approach for treating CD. However, larger trials are needed to confirm its long-term benefits and refine its clinical applications.
Crohn’s disease is a chronic inflammatory disorder with variable progression that often leads to hospitalization, treatment escalation, or surgery. While clinical and endoscopic indices guide disease monitoring, cross-sectional enterography provides unique visualization of transmural and extramural inflammation, offering valuable prognostic information. This systematic review and meta-analysis examined the prognostic significance of magnetic resonance enterography (MRE) and computed tomography enterography (CTE) in Crohn’s disease. Following PRISMA guidelines and a registered protocol, eight databases were systematically searched through August 2024. Two reviewers independently conducted data extraction, risk-of-bias assessment (QUADAS-2), and certainty grading (GRADE). Random-effects models were applied for pooled analyses. Eleven studies, including more than 1500 patients, met eligibility criteria. Across cohorts, transmural healing on enterography was consistently associated with favorable long-term outcomes, including a markedly lower need for surgery and hospitalization. Conversely, stenosis and persistent inflammatory activity identified patients at substantially higher risk of surgery, treatment intensification, or disease-related hospitalization. The certainty of evidence was high for surgical outcomes and moderate to low for other endpoints. Conventional enterography provides meaningful prognostic insight into Crohn’s disease and should be considered a complementary tool for risk stratification and treatment planning. Transmural healing represents a protective marker of a favorable disease course, whereas structural and inflammatory findings indicate patients who may benefit from closer monitoring or earlier therapeutic intervention.