The effect of drugs and stem cell therapies on established abdominal aortic aneurysms in mice: A systematic review and meta-analysis

BACKGROUND: Effective pharmacological therapies for small abdominal aortic aneurysms (AAAs) have not been identified. Most preclinical work focuses on aneurysm initiation rather than established disease, reducing translational relevance. METHODS: We conducted a systematic review and meta-analysis of murine studies evaluating pharmacological or stem cell-based interventions on established small AAAs. Forty-three studies met inclusion criteria, and 35 (n = 1163 mice) provided quantitative data. Aneurysms were induced using angiotensin II, calcium chloride, or elastase. RESULTS: = 10.5%; p = 0.03). Only anti-inflammatory drugs significantly reduced rupture incidence (risk ratio 0.40; 95% CI 0.18-0.89). Risk of bias was moderate-to-high across most studies, with indications of potential publication bias. CONCLUSION: Targeting inflammation, proteolysis, thrombosis, and vascular remodelling can attenuate progression of established small AAAs in mice, with anti-inflammatory therapy uniquely demonstrating protection against rupture.