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

Phlebotropic therapy is an important component of the pathogenetic treatment of chronic venous insufficiency (CVI) of the lower extremities. Venoactive drugs, which have proven their effectiveness and safety in a variety of studies, are widely represented in international and Russian clinical guidelines and standards. However, there is no consensus on the regulation of phlebotropic therapy and, above all, its duration in different clinical classes of CVI. In addition, there are no clear indications on the methods of treatment efficacy monitoring, which can be used in real clinical practice. The presented systematized review of the literature data on micronized purified flavonoid fraction not only reveals the possibilities of phlebotropic therapy of different clinical classes and forms of CVI, but also suggests effective regulations for the use of this drug in specific situations. The data concerning the efficacy of phlebotropic therapy in real clinical practice at the initial stages of CVI (C0s-C1s), in the treatment of C2s (varicose superficial veins with venospecific symptoms), C3 (chronic venous edema), C4 (trophic skin disorders), as well as in stages C5-C6 and C6r (venous trophic ulcers) are presented in details. In addition, the results of studies on the use of micronized purified flavonoid fraction in phlebosclerosing treatment are presented. The duration of phlebotropic therapy is in direct relation to the severity of the disease and the response to the ongoing treatment. The important role is played not only by personalization of treatment according to specific symptoms and syndromes, but also, if possible, by objective control of their dynamics.

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CONSERVATIVE TREATMENT OF HEMORRHOIDS. AN ALTERNATIVE TO SURGICAL METHODS OR COMPONENTS? CHORUS PROGRAM RESULTS

Koloproktologia ◽

10.33878/2073-7556-2018-0-1-27-35 ◽

2018 ◽

pp. 27-35

Author(s):

E. A. Zagryadskiy ◽

A. M. Bogomazov ◽

E. B. Golovko

Keyword(s):

Surgical Treatment ◽

Conservative Treatment ◽

Clinical Manifestations ◽

Entire Observation Period ◽

Surgical Methods ◽

Micronized Purified Flavonoid Fraction ◽

Flavonoid Fraction ◽

Observational Group ◽

Grade Iii ◽

Observation Period

OBJECTIVE. Determine the frequency of clinical manifestations of hemorrhoids and constipation in people seeking advice about hemorrhoids. In the course of the treatment of patients with hemorrhoids phlebotropic evaluate the effectiveness of therapy micronized purified flavonoid fraction (MPFF). MATERIALS AND METHODS. This multicenter study, including screening and observation part, which is part of the International Research «CHORUS» (Chronic venous and hemorrhoid diseases evaluation and scientific research), conducted in nine centers in different regions of Russia, 80 doctors of Coloproctology. In the screening group included 2668 patients who had investigated the incidence of constipation, as a risk factor for hemorrhoids. Conservative treatment, the foundation of which was, Moffitt therapy, received 1952 patients with stage I-IV hemorrhoids. Evaluating the effectiveness of the treatment was evaluated on the basis of a questionnaire. RESULTS. The questionnaire shows that constipation suffered - 766 (28,8 %) patients. Violation of defecation patterns and changes in stool consistency was observed in 1155 (43,9%) and 633 (25.5 %), respectively. At the same time, 288 (11,1 %) indicated a tendency to loose stools and diarrhea. Conservative treatment, the foundation of which is phlebotropic MPFF therapy conducted in patients of observational group has shown its efficiency in all grades of hemorrhoids. During the entire observation period of conservative treatment was effective in 1489 (76,3 %) patients. Surgical treatment was performed in 463 (23 %) patients grade I-IV hemorrhoids, the main part of patients with grade III -199 (43,1 %) and grade IV hemorrhoids - 68 (64,2 %). CONCLUSION. Conservative treatment of hemorrhoid disease, which is the basis on phlebotropic MPFF therapy, is effective at all stages of hemorrhoids, but in patients with grade III and grade IV disease requires surgical treatment.

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Micronized purified flavonoid fraction in the treatment of hemorrhoidal disease

Journal of Comparative Effectiveness Research ◽

10.2217/cer-2021-0038 ◽

2021 ◽

Author(s):

Philippe Godeberge ◽

Parvez Sheikh ◽

Varut Lohsiriwat ◽

Abel Jalife ◽

Yury Shelygin

Keyword(s):

Normal Activity ◽

Hemorrhoidal Disease ◽

Supporting Evidence ◽

First Line ◽

Adjunct Treatment ◽

Anal Discharge ◽

Venoactive Drugs ◽

Micronized Purified Flavonoid Fraction ◽

Flavonoid Fraction

Hemorrhoidal disease (HD) is common in adults. Treatment is largely conservative, although more invasive procedures may be required. Venoactive drugs such as micronized purified flavonoid fraction (MPFF) are widely used, but a recent and comprehensive review of supporting evidence is lacking. In acute HD, MPFF can reduce HD symptoms such as bleeding, pain, anal discomfort, anal discharge and pruritus. In patients undergoing surgery, postoperative adjunct MPFF consistently reduces pain, bleeding duration and use of analgesia. MPFF treatment is appropriate and effective both as a first-line conservative treatment and as a postoperative adjunct treatment. MPFF reduces the duration of hospital stay following surgery, facilitating a return to normal activity and improving quality of life. MPFF may also prevent HD recurrence.

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