Is there a role for adjunctive therapy for patients with venous stasis ulcers ?
Varatharajan and colleeagues performed a literature search to determine if pharmacologic adjuncts are helpful in healing venous stasis ulceers.
"Ten relevant articles were identified; one pilot randomised controlled trial and four Cochrane reviews were included. Pentoxifylline, aspirin, sulodexide, mesoglycan, flavonoids, thromboxane A2 antagonist (ifetroban), zinc, prostaglandin and prostacyclin analogues were the drugs reviewed. Pentoxifylline was found to be more effective than placebo in terms of complete ulcer healing or in causing a significant improvement (greater than 60% reduction in ulcer size) (RR 1.70, 95% CI 1.30 to 2.24)".
The study was published in Phlebology 2016; 31: 356-365 by Varatharajan L, Thapar A, Lane T, Munster AB and Davies AH.
The authors concuded that pentoxifylline 400 mg taken three times a day is "currently the only drug that has proising evidence to support its use (to heal venous stasis ulcers)".
Dr Karamanoukian's comment: we use extended release pentoxifylline, 400 mg daily, as an adjunct to help heal venous stasis ulcers.