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Medikamentöse Behandlung chronischer Venenerkrankungen

Drug Treatment of Chronic Venous Diesease

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Zusammenfassung

Chronische Venenerkrankungen (CVE) betreffen zumindest 15–25 % der Allgemeinbevölkerung und sind nicht nur mit hoher Morbidität, sondern auch mit beträchtlichen finanziellen Belastungen verbunden. Die moderne CVE-Behandlung stützt sich vor allem auf endovenöse therapeutische Verfahren und Kompressionstherapie. Je mehr Einblicke wir allmählich in die Pathogenese der CVE gewinnen, desto mehr steigt auch das Interesse an Arzneimitteln, die diesen Prozess beeinflussen können. Nachfolgend finden Sie einen Überblick über die meisten oralen Präparate, die derzeit zur Behandlung von CVE (einschließlich venöser Beingeschwüre) eingesetzt werden. Nach mehreren Jahrzehnten klinischer Verwendung liegen für einige Flavonoidpräparate, in erster Linie für MPFF (mikronisierte gereinigte Flavonoidfraktion), genügend Nachweise vor, um sie als kurzfristige Zusatzbehandlung bei CVE empfehlen zu können. Andere Verbindungen sind jedoch diesbezüglich ebenfalls äußerst vielversprechend. Dennoch benötigen wir mehr umfassendere klinische Studien über einen längeren Zeitraum hinweg, um Wirkung, Kosteneffizienz und vor allem eine mögliche prophylaktische Anwendung dieser Medikamente genauer definieren zu können. Mehr über die Grundlagen von CVE zu erfahren hilft uns bei der Entwicklung neuer Arzneimittel, die auf spezielle Aspekte des Erkrankungsprozesses ausgerichtet sind.

Summary

Chronic venous disease (CVD) affects at least 15–25 % of the general population incurring not only high morbidity but also considerable economical burden. The mainstay of modern treatment of CVD are endovenous therapeutic procedures and compression therapy. As far as the pathogenesis of CVD is being gradually unraveled the interest in drugs able to impact the process is growing. Here we have presented an overview of a majority of oral preparations used so far to treat CVD including venous leg ulcers. After several decades of clinical use a few flavonoid preparations, in the first place micronized purified flavonoid fraction, collected enough evidence to recommend them as a short-term adjunct treatment of CVD. However, other compounds are also promising in this regards. Yet, we need more larger and longer-term clinical trials to more precisely define effects, cost-effectiveness and, above all, capacity for prophylactic application of the drugs. Learning more about basis of CVD will help design new drugs directed at specific aspects of the disease process.

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  1. Dermatologiezentrum Parmova, Parmova 53, 1000, Ljubljana, Slowenien

    Miloš D. Pavlović

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Pavlović, M.D. Medikamentöse Behandlung chronischer Venenerkrankungen. Wien Med Wochenschr 166, 312–319 (2016). https://doi.org/10.1007/s10354-016-0480-z

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