“…In such conditions oral SET may be used as adjunctive therapy to compression and other effective treatment modalities. 15 Combinations of the enzymes trypsin and bromelain, along with the bioflavonoid Rutoside, is available for use as SET in many countries, since many decades. In India, this combination is available in different formulationsdispersible (example-Disperzyme), enteric-coated (example-Phlogam), and strengths.…”
Chronic venous disease (CVD), a sequel of venous insufficiency, has great medical and socioeconomic impact. Varicose veins and venous ulcer are amongst its commonest manifestations. In CVD, incompetent valves, weakened vascular walls, venous hypertension and increased permeability of venous walls lead to the release of proinflammatory mediators like tumor necrosis factor (TNF)-α, interleukin (IL)-1β, reactive oxygen species (R.O.S.), and reactive nitrogen species (R.N.S.) in the venous milieu. Pharmacotherapy with nonsteroidal anti-inflammatory drugs (NSAIDs) is often used to relieve pain caused by venous disease. However, there is a need for therapies that target the microcirculatory disorders and act on chronic inflammatory processes. Systemic enzyme therapy (SET), with orally administered combination of proteolytic enzymes- trypsin, bromelain, and flavonoid rutoside, has been used since decades for their anti-inflammatory, analgesic, anti-edematous, antithrombotic and antioxidant properties. This review discusses the various relevant pharmacodynamic properties demonstrated by the ingredients, followed by clinical studies of SET, which have demonstrated benefit in both subjective and objective parameters. These studies indicate that SET has good efficacy, tolerability and holds great promise to improve the quality of life of a patient with CVD.
“…In such conditions oral SET may be used as adjunctive therapy to compression and other effective treatment modalities. 15 Combinations of the enzymes trypsin and bromelain, along with the bioflavonoid Rutoside, is available for use as SET in many countries, since many decades. In India, this combination is available in different formulationsdispersible (example-Disperzyme), enteric-coated (example-Phlogam), and strengths.…”
Chronic venous disease (CVD), a sequel of venous insufficiency, has great medical and socioeconomic impact. Varicose veins and venous ulcer are amongst its commonest manifestations. In CVD, incompetent valves, weakened vascular walls, venous hypertension and increased permeability of venous walls lead to the release of proinflammatory mediators like tumor necrosis factor (TNF)-α, interleukin (IL)-1β, reactive oxygen species (R.O.S.), and reactive nitrogen species (R.N.S.) in the venous milieu. Pharmacotherapy with nonsteroidal anti-inflammatory drugs (NSAIDs) is often used to relieve pain caused by venous disease. However, there is a need for therapies that target the microcirculatory disorders and act on chronic inflammatory processes. Systemic enzyme therapy (SET), with orally administered combination of proteolytic enzymes- trypsin, bromelain, and flavonoid rutoside, has been used since decades for their anti-inflammatory, analgesic, anti-edematous, antithrombotic and antioxidant properties. This review discusses the various relevant pharmacodynamic properties demonstrated by the ingredients, followed by clinical studies of SET, which have demonstrated benefit in both subjective and objective parameters. These studies indicate that SET has good efficacy, tolerability and holds great promise to improve the quality of life of a patient with CVD.
“…Como adjuvante da terapia de compressão, o tratamento com pentoxifilina ou flavonóides purificados micronizados é uma medida auxiliar eficaz. Estes medicamentos têm sido eficazes na melhora da cicatrização de úlceras e atualmente têm sido recomendados para úlceras grandes e/ou de longa duração (Nair, 2014;O'Donnell et al, 2014).…”
Objetivo: Analisar as principais evidências clínicas acerca dos tratamentos tópicos atuais para úlcera venosa de perna. Metodologia: Trata-se de uma revisão sistemática realizada por meio do método PRISMA, nas bases de dados eletrônicas PubMed, Scopus e Web of Science, por meio dos seguintes descritores: “venous ulcer” “topical treatment”, “topical management”, “topical wound care” e “dressing”. Foram incluídos textos completos, disponíveis em português, inglês ou espanhol, publicados entre janeiro de 2018 a julho de 2022. Além destes critérios, foram incluídos apenas estudos que abordavam produtos tópicos de tratamento de feridas para gerenciamento de úlceras venosas de perna. Resultados: 12 artigos compuseram a amostra final desse estudo, com maior produção em 2020 (n: 05). Verificou-se uma notável variedade de produtos tópicos para o tratamento de úlceras venosas de perna: aloenxerto de membrana de âmnio/córion humano desidratado, plasma rico em plaquetas autólogo, fatores de crescimento concentrados, tecido adiposo centrifugado, membrana de biopolímero de matriz natural, cobertura de colagenase, papaína 2-4% com bota de Unna, timolol tópico, pomada de iodo cadexômero a 0,9% e ácido hialurônico. Conclusão: Diversos produtos tópicos para o tratamento de úlceras venosas de perna foram identificados na literatura científica, apresentando resultados positivos em relação à cicatrização, redução da área da lesão e melhora da dor nos pacientes acometidos.
“…The article venous leg ulcer: Systemic therapy by B Nair[ 1 ] was very well-written. Systemic therapy for leg ulcerations is usually only supportive to the central theme of management, as has already been brought out by the author very succinctly.…”
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