Benefits of micronized purified flavonoid fraction as adjuvant therapy on inflammatory response after sclerotherapy

Богачев, В. Ю.; Болдин, Б. В.; Лобанов, В. Н.

doi:10.23736/s0392-9590.17.03868-8

Cited by 28 publications

(8 citation statements)

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“…29,30 Furthermore, MPFF and non-micronized diosmin have demonstrated a broad anti-inflammatory activity through the inhibition of leukocyte adhesion to the vascular endothelium and the reduction of pro-inflammatory factor expression (eg, TNF-α, IL-6). 31,32 This literature review identified three well-conducted multicenter randomized clinical trials with appropriate methodology comparing MPFF and non-micronized diosmin and providing consistent results. Taken all together, they indicate that clinical symptoms of CVD are improved with both treatments and that there are no significant differences between these two diosmin preparations.…”

Section: Discussionmentioning

confidence: 84%

Is There a Difference in the Clinical Efficacy of Diosmin and Micronized Purified Flavonoid Fraction for the Treatment of Chronic Venous Disorders? Review of Available Evidence

Cazaubon

Benigni

Steinbruch³

et al. 2021

VHRM

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Flavonoids are oral venoactive drugs frequently prescribed to relieve the symptoms of chronic venous disorders (CVD). Among venoactive drugs, diosmin is a naturally occurring flavonoid glycoside that can be isolated from various plant sources; it can also be obtained after conversion of hesperidin extracted from citrus rinds. Micronized purified flavonoid fraction (MPFF) is a preparation that contains mainly diosmin and a small fraction of hesperidin. We performed a state-of-the-art literature review to collect and analyze well-conducted randomized clinical studies comparing diosmin – also called non-micronized or hemisynthetic diosmin – 600 mg a day and MPFF, 1000 mg a day. Three clinical studies met the criteria and were included for this literature review. These clinical studies showed a significant decrease of CVD symptom intensity (up to approximately 50%) and global patient satisfaction after one-to-six-month treatment with diosmin or MPFF, without statistical differences between these two forms of diosmin. Both treatments were well tolerated with few mild adverse drug reactions reported. Overall, based on this literature review, there is no clinical benefit to increase the dose of diosmin beyond 600 mg per day, to use the micronized form, or to add hesperidin, since clinical efficacy on venous symptomatology is achieved with 600 mg per day of pure non-micronized diosmin. This challenges the status of diosmin – 600 mg a day – in guidelines for the management of CVD, which is currently categorized 2C (weak recommendations for use and poor quality of evidence), while the most widely used and assessed preparation MPFF is rated 1B (strong recommendation for use and moderate quality of evidence).

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Section: Discussionmentioning

confidence: 84%

Is There a Difference in the Clinical Efficacy of Diosmin and Micronized Purified Flavonoid Fraction for the Treatment of Chronic Venous Disorders? Review of Available Evidence

Cazaubon

Benigni

Steinbruch³

et al. 2021

VHRM

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“…Endothelial destruction is accompanied by the expression of pro-inflammatory cytokines and growth factors inducing a local venospecific inflammatory response. Administration of MPFF 2 weeks prior to and for 2 months after sclerotherapy has been shown to lower the levels of inflammation and endothelial dysfunction markers (histamine, C-reactive protein, interleukin-1, tumor necrosis factor-α, and endothelial vascular growth factor) in venous blood samples [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…The use of venoactive drugs can facilitate the recovery process following saphenous vein high ligation and stripping, laser or RFA, and sclerotherapy [ 19 ]. Several open-label clinical trials have demonstrated that venoactive drugs are effective after surgery, endovenous thermal ablation (laser, radiofrequency), and sclerotherapy [ 20 – 23 ]. The latest systematic review on the use of venoactive drugs in this setting illustrates the benefit of MPFF in terms of reducing post-procedural pain, hematoma count and area, and VV symptoms [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Micronized Purified Flavonoid Fraction-Based Venoactive Therapy After Endovenous Mechanochemical Obliteration: Prospective Comparative Study

Khryshchanovich

Nebylitsin

Косинец

2021

Drugs - Real World Outcomes

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Background Endovenous interventions and minimally invasive open procedures are effective in the management of varicose veins, but can result in post-operative pain/discomfort.Objective The objective of this study was to evaluate the clinical efficacy of micronized purified flavonoid fraction venoactive therapy for postoperative pain, vein-specific symptoms, and quality of life in patients with varicose veins following an endovenous mechanochemical ablation procedure. Methods This prospective, observational, single-center study allocated patients into two groups: Group A, micronized purified flavonoid fraction 1000 mg once daily for 30 days; Group B, no venoactive drug prescribed (control). The Clinical-Etiology-Anatomy-Pathophysiology classification system for chronic venous disorders was used to assess varicose veins; a 10-point Visual Analog Scale assessed pain syndrome intensity; the Venous Clinical Severity Score measured overall varicose vein severity; and the Chronic Venous Insufficiency QoL Questionnaire measured total quality of life. Results The study enrolled 58 patients (mean age 36.9 ± 4.1 years; 24 men) with varicose veins of C2-C4 who underwent truncal mechanochemical ablation plus mini-phlebectomy or foam sclerotherapy. Group A had significantly lower pain syndrome at days 14 and 30 compared with Group B (1.76 vs 2.20, p = 0.039; 1.38 vs 2.07, p = 0.003, respectively), and clinical symptom severity at day 30 (2.67 vs 3.13, p = 0.05). Significant differences in quality-of-life scores existed between groups at days 14 and 30 (15.21 vs 18.75, p = 0.008; 12.98 vs 16.33, p = 0.001). No micronized, purified flavonoid, fraction-related adverse effects were observed. Conclusions Micronized purified flavonoid fraction-based venoactive adjuvant therapy after mechanochemical ablation alleviated pain, reduced the severity of symptoms, and improved the quality of life in patients with varicose veins.

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“…V pokročilých stadiích symptomatického CHŽO mohou být venofarmaka používána spolu s intervenční léčbou (skleroterapie, klasická nebo endovenózní operace). Několik prací, včetně dvou RCT, prokázalo přínos podávání venofarmak bezprostředně po operaci varixů (19,20).…”

Section: Na Začátku Byla Metaanalýzaunclassified

Development of recommendations for the use of venoactive drugs in the treatment of chronic venous disease - where they are effective and where they are not

Musil¹

2022

Vnitr Lek

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Interní a kardiologická klinika Fakultní nemocnice Ostrava a LF Ostravské univerzity Článek podává přehled vývoje doporučení pro indikace venofarmak k ovlivnění symptomů a známek spojených s chronickým žilním onemocněním (CHŽO). Venofarmaka mohou být prospěšná u pacientů se subjektivními potížemi a/nebo otoky dolních končetin, po operacích varixů, při chronické žilní insuficienci nebo při poruchách mikrocirkulace. Nejsou indikována u asymptomatických pacientů ani v prevenci vzniku a rozvoje varixů. Při výběru preparátu by měla být dána přednost přípravkům, jejichž účinek byl prokázán klinickými studiemi.

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Benefits of micronized purified flavonoid fraction as adjuvant therapy on inflammatory response after sclerotherapy

Cited by 28 publications

References 0 publications

Is There a Difference in the Clinical Efficacy of Diosmin and Micronized Purified Flavonoid Fraction for the Treatment of Chronic Venous Disorders? Review of Available Evidence

Is There a Difference in the Clinical Efficacy of Diosmin and Micronized Purified Flavonoid Fraction for the Treatment of Chronic Venous Disorders? Review of Available Evidence

Efficacy of Micronized Purified Flavonoid Fraction-Based Venoactive Therapy After Endovenous Mechanochemical Obliteration: Prospective Comparative Study

Development of recommendations for the use of venoactive drugs in the treatment of chronic venous disease - where they are effective and where they are not

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