Konsensuspapier zur symptomorientierten Therapie der chronischen Venenerkrankungen

Stücker, Markus; Debus, Eike Sebastian; Hoffmann, Johannes N.; Jünger, Michael; Kröger, Knut; Mumme, A.; Ramelet, Albert‐Adrien; Rabe, Eberhard

doi:10.1111/ddg.13006_g

Cited by 7 publications

(4 citation statements)

References 41 publications

(58 reference statements)

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“…Die Therapie sollte, wann immer möglich, kausal orientiert erfolgen und mindestens eine suffiziente Kompressionstherapie beinhalten . Vorhandene strukturelle Veränderungen sollten, wenn möglich, ablativ oder operativ eradiziert werden .…”

Section: Ulcus Cruris Venosumunclassified

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Systemische Therapien des Ulcus cruris

Dissemond

Erfurt‐Berge

Goerge

et al. 2018

J Deutsche Derma Gesell

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ZusammenfassungFür eine erfolgreiche Behandlung von Patienten mit Ulcus cruris ist es essentiell, die zugrundeliegende Ätiologie zu klären und, wenn möglich, eine kausale Therapie einzuleiten. Begleitend ist die an den Phasen der Wundheilung orientierte Wundbehandlung, meist in Verbindung mit einer Kompressionstherapie, die Therapie der Wahl. Der Stellenwert der systemischen Therapien wird in Abhängigkeit der zugrundeliegenden Genese sehr unterschiedlich und oft kontrovers beurteilt. In diesem Übersichtsartikel werden die aktuellen Aspekte der systemischen medikamentösen Therapien für Patienten mit Ulcus cruris bei den häufigen Genesen chronische venö-se Insuffizienz, periphere arterielle Verschlusskrankheit, Livedovaskulopathie, Vaskulitis, Necrobiosis lipoidica, Calciphylaxie und Pyoderma gangraenosum differenziert vorgestellt und kritisch diskutiert.Zusammenfassend kann festgestellt werden, dass es sich bei vielen der hier vorgestellten Therapien um einen Off-Label-Use handelt. Bei den häufiger vorkommenden Wundarten wie beispielsweise Ulcus cruris venosum, mixtum und arteriosum sind Medikamente für die Therapie zwar hoffnungsvolle Optionen, bisher aber in der Regel kein Behandlungsstandard. Im Gegensatz hierzu haben systemische Therapien bei den anderen hier vorgestellten Krankheitsbildern eine meist zentral wichtige Bedeutung. Es sind in erster Linie immunmodulierende und rheologisch wirksame Medikamente, die eingesetzt werden, um die Wundheilung zu beschleunigen. SummarySuccessful management of patients with leg ulcers requires identification of the underlying etiology, with subsequent initiation of causal treatment, if feasible. Supplementary measures of first choice include stage-adjusted wound treatment, usually combined with compression therapy. The significance of systemic drugs has been the subject of controversial debate, depending on the underlying cause of the condition. The present review article is therefore meant to highlight current aspects of systemic drug therapies for the treatment of leg ulcers associated with chronic venous insufficiency, peripheral arterial disease, livedoid vasculopathy, vasculitis, necrobiosis lipoidica, calciphylaxis and pyoderma gangrenosum.In summary, the majority of therapeutic options presented herein are used off-label. While systemic drugs are promising options for the more common types of wounds such as venous, mixed or arterial leg ulcers, they do not represent the

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Section: Ulcus Cruris Venosumunclassified

“…Für die symptomatische Therapie der CVI sowie für die Ödemreduktion stehen in Deutschland folgende Substanzen mit evidenzbasierter Wirksamkeit zur Verfügung: Calciumdobesilat , Oxerutin , standardisierter Rosskastanienextrakt , standardisierter roter Weinlaubextrakt AS 195 .…”

Section: Ulcus Cruris Venosumunclassified

Systemische Therapien des Ulcus cruris

Dissemond

Erfurt‐Berge

Goerge

et al. 2018

J Deutsche Derma Gesell

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“…Whenever possible, treatment should be geared towards fixing the underlying cause and at least include adequate compression therapy . If possible, existing structural changes should be eradicated by ablation or surgery .…”

Section: Venous Leg Ulcermentioning

confidence: 99%

“…In Germany, the following substances with evidence‐based efficacy are available for symptomatic treatment of CVI and edema reduction: calcium dobesilate , oxerutin , standardized horse chestnut extract , and standardized red vine leaf extract AS 195 .…”

Section: Venous Leg Ulcermentioning

confidence: 99%

Systemic therapies for leg ulcers

Dissemond

Erfurt‐Berge

Goerge³

et al. 2018

J Deutsche Derma Gesell

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Successful management of patients with leg ulcers requires identification of the underlying etiology, with subsequent initiation of causal treatment, if feasible. Supplementary measures of first choice include stage-adjusted wound treatment, usually combined with compression therapy. The significance of systemic drugs has been the subject of controversial debate, depending on the underlying cause of the condition. The present review article is therefore meant to highlight current aspects of systemic drug therapies for the treatment of leg ulcers associated with chronic venous insufficiency, peripheral arterial disease, livedoid vasculopathy, vasculitis, necrobiosis lipoidica, calciphylaxis and pyoderma gangrenosum. In summary, the majority of therapeutic options presented herein are used off-label. While systemic drugs are promising options for the more common types of wounds such as venous, mixed or arterial leg ulcers, they do not represent the current standard of treatment. By contrast, systemic agents play a key role in the management of many of the other disorders presented herein. These agents primarily include immunomodulatory and rheological drugs used to expedite wound healing.

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Konservatives Management der Varikose und des postthrombotischen Syndroms

2018

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Both varicosis and postthrombotic syndrome are manifestations of chronic venous disease - a widespread disease. Even at an early stage there are visible vascular symptoms, feeling of heaviness and tendency to swelling. In advanced stages, skin alterations and chronic wounds follow. Chronic venous insufficiency as a progressive disease can lead to significant limitations in the quality of life. Adequate diagnosis and therapy is therefore essential. A causal therapy that removes varices or occluding processes should be targeted whenever possible. Accompanying or if a causal therapy is not desired or possible, a symptom-oriented treatment can be considered. The therapy regimen should be individually tailored depending on the leading clinical symptoms, the comorbidities and the patient's wishes. Conservative therapy is the basic measure and should be known to every practitioner.

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Konsensuspapier zur symptomorientierten Therapie der chronischen Venenerkrankungen

Cited by 7 publications

References 41 publications

Systemische Therapien des Ulcus cruris

Systemische Therapien des Ulcus cruris

Systemic therapies for leg ulcers

Konservatives Management der Varikose und des postthrombotischen Syndroms

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