Pentoxifylline for treating venous leg ulcers
ABSTRACT Healing of venous leg ulcers is improved by the use of compression bandaging but some venous ulcers remain unhealed, and some people are unsuitable for compression therapy. Pentoxifylline, a drug which helps blood flow, has been used to treat venous leg ulcers.
To assess the effects of pentoxifylline (oxpentifylline or Trental 400) for treating venous leg ulcers, compared with a placebo or other therapies, in the presence or absence of compression therapy.
For this fifth update we searched the Cochrane Wounds Group Specialised Register (searched 20 July 2012); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 7); Ovid MEDLINE (2010 to July Week 2 2012); Ovid MEDLINE (In-Process & Other Non-Indexed Citations, July 19, 2012); Ovid EMBASE (2010 to 2012 Week 28); and EBSCO CINAHL (2010 to July 13 2012).
Randomised trials comparing pentoxifylline with placebo or other therapy in the presence or absence of compression, in people with venous leg ulcers.
One review author extracted and summarised details from eligible trials using a coding sheet. One other review author independently verified data extraction.
No new trials were identified for this update. We included twelve trials involving 864 participants. The quality of trials was variable. Eleven trials compared pentoxifylline with placebo or no treatment. Pentoxifylline is more effective than placebo in terms of complete ulcer healing or significant improvement (RR 1.70, 95% CI 1.30 to 2.24). Pentoxifylline plus compression is more effective than placebo plus compression (RR 1.56, 95% CI 1.14 to 2.13). Pentoxifylline in the absence of compression appears to be more effective than placebo or no treatment (RR 2.25, 95% CI 1.49 to 3.39).More adverse effects were reported in people receiving pentoxifylline (RR 1.56, 95% CI 1.10 to 2.22). Nearly three-quarters (72%) of the reported adverse effects were gastrointestinal.
Pentoxifylline is an effective adjunct to compression bandaging for treating venous ulcers and may be effective in the absence of compression. The majority of adverse effects were gastrointestinal disturbances.
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ABSTRACT: In this study, we examined the ability of Pentoxifylline (PTX) to prevent sleep deprivation induced memory impairment probably through decreasing oxidative stress. Sleep deprivation was chronically induced 8 hrs/day for 6 weeks in rats using modified multiple platform model. Concurrently, PTX (100 mg/kg) was administered to animals on daily basis. After 6 weeks of treatment, behavioral studies were conducted to test the spatial learning and memory using the Radial Arm Water Maze. Additionally, the hippocampus was dissected; and levels/activities of antioxidant defense biomarkers glutathione reduced (GSH), glutathione oxidized (GSSG), GSH/GSSG ratio, glutathione peroxidase (GPx), catalase, and superoxide dismutase (SOD), were assessed. The results show that chronic sleep deprivation impaired short- and long- term memories, which was prevented by chronic treatment with PTX. Additionally, PTX normalized sleep deprivation-induced reduction in the hippocampus GSH/GSSG ratio (P < 0.05), and activities of GPx, catalase, and SOD (P < 0.05). In conclusion, chronic sleep deprivation induces memory impairment, and treatment with PTX prevented this impairment probably through normalizing antioxidant mechanisms in the hippocampus. © 2013 Wiley Periodicals, Inc.Hippocampus 09/2013; 23(9). DOI:10.1002/hipo.22135 · 4.30 Impact Factor
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ABSTRACT: Introduction: Close to 5 million people in the USA are affected by chronic wounds, and billions of dollars are spent annually for their treatment. Despite advances in chronic wound management over the past decades, many patients afflicted with chronic wounds fail to heal or their ulcers recur. There is emerging evidence that the use of bone marrow-derived mesenchymal stem cells (BM-MSCs) can offset this situation of impaired healing. Areas covered: This article provides a review of the use of BM-MSC for the treatment of chronic wounds, the current development of stem cell delivery to chronic wounds and related challenges are also described in this manuscript. Expert opinion: Numerous animal studies and a few pilot studies in human wounds have shown that BM-MSC can augment wound closure. Still, the primary contribution of mesenchymal stem cells (MSCs) to cutaneous regeneration and the long-term systemic effects of MSCs are yet to be established. In addition, we need to determine whether other types of stem/progenitor cells will be more effective. Therefore, more randomized controlled clinical trials need to be undertaken. It is of importance to remember that even with the most advanced and sophisticated therapeutic approaches, proper wound care and adherence to basic principles remain critical.Expert Opinion on Emerging Drugs 09/2013; 18(4). DOI:10.1517/14728214.2013.833184 · 3.28 Impact Factor
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ABSTRACT: Venous leg ulcers (VLUs) are chronic leg wounds that can have a debilitating effect on the physical and psychological health of patients. Older patients, who are a vulnerable group, suffer from VLUs more frequently, and the prevalence of these ulcers increases as the population ages. Venous leg ulcers also pose a serious cost to the healthcare industry. Zinc, in the form of topical creams and lotions, has been used in wound care for more than 3,000 years and is now contained in a variety of wound care products that are used in the treatment of chronic VLUs. OBJECTIVE: The aim of this review was to examine the current empirical evidence to assess if topical zinc-based wound products are effective in promoting the healing of VLUs. METHODS: Following a systematic search and review of the literature, based on selected keywords, 11 studies were identified as being relevant, and data were extracted using content analysis. RESULTS: The results show that there is currently very poor-quality evidence to suggest that topical zinc-based wound products are effective in healing VLUs, either in conjunction with compression therapy, as compression bandages themselves, or as a topical skin protectant. Some of the studies were sponsored by industry, which challenges the validity and reliability of their results. CONCLUSIONS: It is apparent that not only was much of the literature conducted on a small scale, it is also outdated and methodologically inconsistent. There is scant high-quality evidence to suggest that topical zinc-based wound products are effective in promoting the healing of VLUs. New studies are urgently needed that are larger, scientifically rigorous, and without bias from industry. This will enable clinicians to implement evidenced-based practice and choose the most appropriate wound management product to improve patient care and reduce the costs of healthcare. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams and Wilkins..Advances in skin & wound care 01/2014; 27(1):35-44. DOI:10.1097/01.ASW.0000439173.79541.96 · 1.63 Impact Factor