Phlebotomy In Treatment Research Articles

Wet Cupping and Phlebotomy in Management of Oligo/Amenorrhea: View of Persian Medicine

Oligo/amenorrhea is one of the most common women’s complaints. The most frequent pathologic causes of this condition is polycystic ovaries that leads to unovulatory cycles. Because of insufficiency of treatment in conventional medicine, we studied view point of Persian Medicine. We searched main Persian Medicine references to collect important information about wet-cupping and phlebotomy in treatment of oligo/amenorrhea especially in patients with Polycystic Ovarian Syndrome. For gathering evidence that establish this idea, we searched main English and Persian language databases for studies about effectiveness of wet-cupping and phlebotomy on menstruation. Excretion blood from lower extremities especially saphenous vein phlebotomy and calves wet-cupping while massive blood excreting is recommended by Persian physicians in Ehtebas-e-tams (oligo/amenorrhea). From the 106 citations identified from electronic searches, at beginning, 3 ones meet our study objectives. These articles showed that wet-cupping effect on menstruation in women with PCOS and fertilization. Although any study didn’t find about effectiveness of phlebotomy on menstruation or fertilization, but majority studies show effect of phlebotomy or blood donation on decrease of insulin resistance. More research about treating this condition needed to confirm the affectiveness of phlebotomy or wet-cupping in treatment of oligo/amenorrhea.

Exam 2: Low-Dose Hydroxychloroquine Is as Effective as Phlebotomy in Treatment of Patients With Porphyria Cutanea Tarda

Exam 2: Low-Dose Hydroxychloroquine Is as Effective as Phlebotomy in Treatment of Patients With Porphyria Cutanea Tarda

Low-Dose Hydroxychloroquine Is as Effective as Phlebotomy in Treatment of Patients With Porphyria Cutanea Tarda

Porphyria cutanea tarda (PCT) is an iron-related disorder caused by reduced activity of hepatic uroporphyrinogen decarboxylase; it can be treated by phlebotomy or low doses of hydroxychloroquine. We performed a prospective pilot study to compare the efficacy and safety of these therapies. We analyzed data from 48 consecutive patients with well-documented PCT to characterize susceptibility factors; patients were treated with phlebotomy (450 mL, every 2 weeks until they had serum ferritin levels of 20 ng/mL) or low-dose hydroxychloroquine (100 mg orally, twice weekly, until at least 1 month after they had normal plasma levels of porphyrin). We compared the time required to achieve a normal plasma porphyrin concentration (remission, the primary outcome) for 17 patients treated with phlebotomy and 13 treated with hydroxychloroquine. The time to remission was a median 6.9 months for patients who received phlebotomy and 6.1 months for patients treated with hydroxychloroquine treatment (6.7 and 6.5 mo for randomized patients), a difference that was not significant (log-rank, P = .06 and P = .95, respectively). The sample size was insufficient to confirm noninferiority of hydroxychloroquine treatment (hazard ratio, 2.19; 95% confidence interval, 0.95-5.06) for all patients. Patients who received hydroxychloroquine had substantially better compliance. There were no significant side effects of either treatment. Hydroxychloroquine, 100 mg twice weekly, is as effective and safe as phlebotomy in patients with PCT, although noninferiority was not established. Given these results, higher-dose regimens of hydroxychloroquine, which have more side effects, do not seem justified. Compliance was better and projected costs were lower for hydroxychloroquine than phlebotomy treatment. Long-term studies are needed to compare durability of response. ClinicalTrials.gov number, NCT01573754.