Sulodexide in the Treatment of Chronic Venous Insufficiency: Results of the All-Russian Multicenter ACVEDUCT Program

Abstract

Sulodexide was a safe and effective medication in the treatment of a cohort of patients with lower extremity chronic venous insufficiency (CVI). This multicenter prospective observational Russian study enrolled 2263 patients with various stages of CVI, mainly classes C3 and C4, who were routinely prescribed sulodexide. Symptom improvement was seen in 56.4%, and 42.8% reported a decreased number of symptoms, mainly after about 2 weeks of treatment and in those aged 30 to 40 years. Sulodexide, used in many countries outside the United States, is a mixture of glycosaminoglycans extracted from porcine intestinal mucosa including low-molecular-weight heparin and dermatan sulfate. It is a lipid-lowering, antithrombotic, and anti-inflammatory agent, decreasing viscosity. It has been used for the management of venous disease and venous ulcerations and for the prevention of recurrent thromboembolism. There are reports of efficacy in advanced stages of CVI, but not routine use. This study overestimates the effectiveness of this drug, adding the results and stating that 99.2% (56.4% plus 42.8%) of patients had improvements. High-quality data are needed.