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Sulodexide in the Treatment of Chronic Venous Disease

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Abstract

Chronic venous disease encompasses a range of venous disorders, including those involving the lower limbs resulting from venous hypertension. The spectrum of chronic venous disease signs and symptoms shows variable severity, ranging from mild (aching, pain, and varicose veins) to severe (venous ulcers). The pathophysiology of chronic venous disease is characterized by venous hypertension, which triggers endothelial dysfunction and inflammation leading to microcirculatory and tissue damage, and eventually to varicose veins and venous ulcers.

Sulodexide is an orally active mixture of glycosaminoglycan (GAG) polysaccharides with established antithrombotic and profibrinolytic activity. The agent is used in the treatment of a number of vascular disorders with increased risk of thrombosis, including intermittent claudication, peripheral arterial occlusive disease and post-myocardial infarction. Sulodexide differs from heparin because it is orally bioavailable and has a longer half-life and a smaller effect on systemic clotting and bleeding. An increasing body of preclinical evidence shows that sulodexide also exerts anti-inflammatory, endothelial-protective, and pleiotropic effects, supporting its potential efficacy in the treatment of chronic venous disease.

Clinical studies of sulodexide have shown that the agent is associated with significant improvements in the clinical signs and symptoms of venous ulcers, and is therefore a recommended therapy in combination with local wound care and bandages for patients with persistent venous leg ulcers. Preliminary evidence supports the use of sulodexide in the prevention of recurrent deep venous thrombosis. Sulodexide was generally safe and well tolerated in clinical trials, without hemorrhagic complications. Sulodexide therefore appears to be a favorable option for the treatment of all stages of chronic venous disease and for the prevention of disease progression.

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Acknowledgments

We thank Nila Bhana, Jo Dalton, and Juliane Weber, who provided medical writing support prior to submission, and Tracy Harrison who provided support post-submission, all of inScience Communications. This support was funded by Alfa Wasserman, Italy. The author participated in the steering committee of the SURVET study, but otherwise has no conflicts of interest that are directly relevant to the content of this review.

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  1. Unitá Operativa di Angiologia, Azienda Ospedaliera, Universitá di Padova, Via Giustiniani 2, 35128, Padua, Italy

    Giuseppe Maria Andreozzi

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Andreozzi, G.M. Sulodexide in the Treatment of Chronic Venous Disease. Am J Cardiovasc Drugs 12, 73–81 (2012). https://doi.org/10.2165/11599360-000000000-00000

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