Bignamini AA, Matuška J, et al.
Advances in therapy. Date of publication 2020 Mar 1;volume 37(3):1013-1033.
1. Adv Ther. 2020 Mar;37(3):1013-1033. doi: 10.1007/s12325-020-01232-1. Epub 2020
Jan 27.
Sulodexide for the Symptoms and Signs of Chronic Venous Disease: A Systematic
Review and Meta-analysis.
Bignamini AA(1), Matuška J(2).
Author information:
(1)Department of Pharmaceutical Sciences, School of Specialisation in Hospital
Pharmacy, University of Milan, Milano, Italy. angelo@aabignamini.it.
(2)Angiologická Ambulance, Hodonín, Czech Republic.
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 I2).
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; I2 = 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.
DOI: 10.1007/s12325-020-01232-1
PMCID: PMC7089759
PMID: 31989486 [Indexed for MEDLINE]
