The Efficacy of Sulodexide in the Prevention of Postthrombotic Syndrome

Luzzi, R; Belcaro, Gianni; Dugall, Mark; Shu, Hu; Arpaia, Guido; Ledda, Andrea; Ippolito, E.; Corsi, M; Ricci, A.; Cotellese, Roberto; Agus, Giovanni B.; Errichi, B. M.; Cornelli, Umberto; Cesarone, M. R.; Hosoi, Morio

doi:10.1177/1076029614533143

Cited by 25 publications

(22 citation statements)

References 45 publications

(54 reference statements)

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“…Sulodexide comprises two fractions: a fastmoving heparin fraction (80%), which has affinity for antithrombin III, and a dermatan sulphate fraction (20%) that has affinity for heparin cofactor II [29]. In clinical trials it has demonstrated efficacy in the treatment/prevention of vascular diseases associated with increased thrombotic risk, including peripheral arterial occlusive diseases [30,31], post-myocardial infarction [32], recurrent deep vein thrombosis [33-35] and post-thrombotic syndrome [36,37].…”

Section: Description Of the Interventionmentioning

confidence: 99%

Sulodexide for the Symptoms and Signs of Chronic Venous Disease: A Systematic Review and Meta-analysis

Bignamini

Matuška²

2020

Adv Ther

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Introduction: Chronic venous disease (CVD) is a common condition associated with valvular dysfunction, venous hypertension and endothelial inflammation. Sulodexide facilitates the healing of venous ulcers and is frequently used in patients with CVD without ulcer. This review assessed the efficacy and safety of sulodexide for treatment of signs and symptoms of lower extremity CVD. Methods: We searched MEDLINE, EMBASE, CINAHL and AMED as well as the Cochrane Central Register of Controlled Trials and the World Health Organisation (WHO) International Clinical Trials Registry Platform Search Portal. We also manually searched potentially relevant journals, conference proceedings and journal supplements. Any study monitoring any effect of sulodexide in patients with CVD at any stage of the disease, classified or non-classified, was considered. Treatment effects were estimated using standardised mean differences (SMDs), mean differences (MDs) and risk ratios (RRs), as appropriate. We calculated 95% confidence intervals (CIs) and heterogeneity (Q, tau and I 2 ). Results: The search found 64 studies, but only 23 provided data on 7153 participants (mean age 55 years; 68% female). The 13 studies providing extractable quantitative information included 1901 participants (mean age 55.2 years; 65% female). Sulodexide decreased the intensity of pain, cramps, heaviness, oedema and total symptom score and reduced inflammatory mediators in patients with CVD. The risk of adverse events (AEs) was not different between sulodexide and placebo or heparan sulphate (RR 1.31, 95% CI 0.74-2.32; I 2 = 0%; 270 participants). The overall risk of AEs with sulodexide was low: 3% (95% CI 1-4%) estimated from 3656 participants. Conclusion: Sulodexide was found to have a beneficial venoactive effect on the major signs and symptoms of CVD such as pain, cramps, heaviness and oedema without increasing the risk of AEs. It is also likely to exert a systemic effect on the course of CVD by interfering with inflammatory chemokines. Key Summary PointsThe majority of validated approaches for the management of chronic venous disease (CVD) are relatively invasive and may be limited by patient acceptance; compression is instead usually associated with poor compliance.This systematic review assessed the efficacy and safety of sulodexide for treatment of signs and symptoms of lower extremity CVD by reviewing the literature and conducting a meta-analysis.Sulodexide had a beneficial venoactive effect on the major signs and symptoms of CVD, such as pain, cramps, heaviness and oedema, without increasing the risk of adverse events. It is also likely to exert a systemic effect on the course of CVD by interfering with inflammatory chemokines.

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Section: Description Of the Interventionmentioning

confidence: 99%

Sulodexide for the Symptoms and Signs of Chronic Venous Disease: A Systematic Review and Meta-analysis

Bignamini

Matuška²

2020

Adv Ther

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“…However, Luzzie et al . evaluated the presence of post‐thrombotic syndrome in a registry of 339 patients after completion of anticoagulation for deep vein thrombosis (DVT) . Patients chose whichever treatment option they preferred: (i) standard management with compression, exercise, and risk factor reduction; (ii) sulodexide 25 mg twice daily plus standard therapy; or (iii) aspirin 100 mg daily plus standard therapy.…”

Section: Cvedmentioning

confidence: 99%

Sulodexide in venous disease

Carroll

Piazza

Goldhaber

2019

Journal of Thrombosis and Haemostasis

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Summary Sulodexide is a glycosaminoglycan extracted from porcine intestinal mucosa. The purpose of this review is to discuss sulodexide's complex pharmacological profile and its clinical applications for venous disease. Sulodexide has wide‐ranging biological effects on the vascular system, including antithrombotic, profibrinolytic, anti‐inflammatory, endothelial protective and vasoregulatory effects. Sulodexide has emerged as a potential therapeutic option for the management of chronic venous insufficiency, including venous ulceration, and the prevention of recurrent venous thromboembolism, with a low rate of major bleeding complications. Sulodexide's pleiotropic vascular effects may facilitate the management of common venous disorders.

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“…The utility of sulodexide in the prophylaxis of post-thrombotic syndrome was also evaluated based on a registry of 339 patients [24]. The incidence of the post-thrombotic syndrome after 60 months was lower in the group receiving sulodexide (12.2% vs. 19.5% in the standard treatment group and 12.2% vs. 23.5% in the aspirin group; P < 0.05 for both analyses).…”

Section: Administration Of Sulodexide In Chronic Venous Diseasementioning

confidence: 99%

Effectiveness and safety of sulodexide in the treatment of venous diseases

Tomkowski

Dybowska

2019

Acta Angiologica

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This article presents a review of the literature assessing the effectiveness and safety of sulodexide in the prophylaxis of deep vein thrombosis and treatment of chronic venous disease. It was demonstrated that sulodexide is effective and safe in the prophylaxis of deep vein thrombosis and treatment of chronic venous insufficiency with ulcers. Sulodexide is characterized by low frequency of bleeding complications.

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The Efficacy of Sulodexide in the Prevention of Postthrombotic Syndrome

Abstract: Sulodexide administration after DVT appears to be effective in preventing PTS in association with recommended management and a number of recurrent DVTs. Modalities of treatment, dosages, and timing of administration should be explored in more comprehensive and complete studies.

Cited by 25 publications

References 45 publications

Sulodexide for the Symptoms and Signs of Chronic Venous Disease: A Systematic Review and Meta-analysis

Sulodexide for the Symptoms and Signs of Chronic Venous Disease: A Systematic Review and Meta-analysis

Sulodexide in venous disease

Effectiveness and safety of sulodexide in the treatment of venous diseases

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