Sun SY, Li Y, Gao YY, Ran XW, et al.
The international journal of lower extremity wounds. Date of publication 2021 Nov 15;volume ():15347346211050769.
1. Int J Low Extrem Wounds. 2021 Nov 15:15347346211050769. doi:
10.1177/15347346211050769. [Epub ahead of print]
Efficacy and Safety of Pentoxifylline for Venous Leg Ulcers: An Updated
Meta-Analysis.
Sun SY(1), Li Y(1), Gao YY(1), Ran XW(1).
Author information:
(1)Innovation Center for Wound Repair, 34753Diabetic Foot Care Center, Department
of Endocrinology and Metabolism, West China Hospital, Sichuan University, 37
Guoxue Lane, Chengdu 610041, Sichuan, People's Republic of China.
The venous leg ulcers are debilitating, painful, and often unresponsive to
advanced dressing treatments, so drugs used locally and systematically are
essential adjuvant therapy-pentoxifylline (PTX) whose anti-inflammatory effects
may offer a promising avenue to treat venous leg ulcers. However, the current
results are controversial. To further evaluate the efficacy and safety of PTX, we
performed an updated meta-analysis of randomized placebo-controlled trials of PTX
in the treatment of venous leg ulcers. We systematically searched multiple
electronic databases PubMed, Web of Science, Embase, the Cochrane Library, the
Cochrane Central Register of Controlled Trials, China Science and Technology
Journal Database, WanFang Data, China National Knowledge Infrastructure, and the
Chinese Biomedical Literature Database to identify eligible studies. Randomized
clinical trials of pentoxifylline versus placebo treatment in patients with
venous leg ulcers were considered for inclusion. The primary outcomes included
ulcer healing rate and the incidence of adverse events after treatment. The
secondary outcomes were the ulcer significant improvement (the ulcer size shrank
by more than 60% after treatment) rate, mean duration of complete wound healing
and changes in mean ulcer size. A meta-analysis and qualitative analysis were
conducted to estimate endpoints. A total of 13 randomized clinical trials,
including 921 individuals, were finally included. Compared with placebo,
pentoxifylline significantly improved the ulcer healing rate (RR = 1.59, 95%CI
1.22 to 2.07, P < .001) and significant improvement rate (RR = 2.36, 95%CI 1.31
to 4.24, P = .004) while increased the incidence of gastrointestinal disturbances
(RR = 2.29, 95%CI 1.04 to 5.03, P = .04) at the same time. Moreover,
pentoxifylline also shortened mean duration of complete wound healing (P = .007)
and shrank ulcer size (P = .02). Currently available evidence suggests that
pentoxifylline could help venous leg ulcers heal more quickly and effectively.
However, the evidence is insufficient to prove the results due to
moderate-certainty evidence. Large-scale, well-designed randomized clinical
trials are warranted.
DOI: 10.1177/15347346211050769
PMID: 34779680
