Vasoprotectives: Efficacy and safety of capillary stabilising agents for venous insufficiency or haemorrhoidal diseases

摘要

Chronic venous insufficiency (CVI) and haemorrhoidal diseases (HD) are very common, severely affecting the quality of life. The aim of this systematic review was to assess the efficacy and safety of a treatment of CVI and HD with capillary-stabilising agents that are listed in the Austrian Code of Reimbursement (EKO). A total of 681 records were identified through a database search, a hand search and via additional industry requests. Studies were selected according to predefined criteria. In the end, 56 studies met our inclusion criteria. Several studies have shown that oxerutin-containing agents (Venoruton®), flavonoid-fraction-containing agents (Daflon®), 50 mg of aescin-containing agents (Venosin retard®) and calcium dobesilate-containing agents (Doxium®) can improve the signs and symptoms of CVI compared to placebo, especially when added to compression stockings. Thus, the strength of evidence of the studies was mostly low. For a treatment of HD, the studies for oxerutin-containing agents and flavonoid fraction containing agents have shown that the severity of signs and symptoms of HD can be reduced slightly further with the agents than with placebo. There were also a few studies for a treatment of CVI or HD with capillary stabilising agents compared to other interventions (such as surgery, etc.), although the evidence was not very comprehensive. However, a treatment with capillary stabilising agents does not seem to be associated with major side effects. We did not identify any evidence to assess the efficacy of 20 mg aescin-containing agents (Reparil®) for a treatment of CVI or HD or of 50 mg aescin (Venosin retard®) and calcium dobesilate (Doxium®) for a treatment of HD. Overall, from the study results and their individual strength of evidence, we are not able to draw any robust conclusions.