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Review

Is There a Difference in the Clinical Efficacy of Diosmin and Micronized Purified Flavonoid Fraction for the Treatment of Chronic Venous Disorders? Review of Available Evidence

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Pages 591-600 | Published online: 16 Sep 2021

References

  • Shami SK, Sarin S, Scurr JH. Chronic venous insufficiency disease. Int J Angiol. 1997;6:30–48. doi:10.1007/BF01616230
  • Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2014;130:333–346. doi:10.1161/CIRCULATIONAHA.113.006898
  • Porter JM, Moneta GL. Reporting standards in venous disease: an update. International consensus committee on chronic venous disease. J Vasc Surg. 1995;21:635–645. doi:10.1016/S0741-5214(95)70195-8
  • Lurie F, Passman M, Meisner M, et al. The 2020 update of the CEAP classification system and reporting standards. J Vasc Surg. 2020;8:342–352.
  • Labropoulos N. How does chronic venous disease progress from the first symptoms to the advanced stages? A review. Adv Ther. 2019;36:13–19. doi:10.1007/s12325-019-0885-3
  • Santler B, Goerge T. Chronic venous insufficiency - a review of pathophysiology, diagnosis, and treatment. J Dtsch Dermatol Ges. 2017;15:538–556.
  • Raffetto JD, Khalil RA. Mechanisms of lower extremity vein dysfunction in chronic venous disease and implications in management of varicose veins. Vessel Plus. 2021;5:36.
  • Feldo M, Woźniak M, Wójciak-Kosior M, et al. Influence of diosmin treatment on the level of oxidative stress markers in patients with chronic venous insufficiency. Oxid Med Cell Longev. 2018;2018:2561705. doi:10.1155/2018/2561705
  • Serra R, Andreucci M, De Caridi G, et al. Functional chronic venous disease: a systematic review. Phlebology. 2017;32:588–592. doi:10.1177/0268355516686451
  • Mansilha A, Sousa J. Pathophysiological mechanisms of chronic venous disease and implications for venoactive drug therapy. Int J Mol Sci. 2018;19:1669. doi:10.3390/ijms19061669
  • Nicolaides A, Kakkos S, Baekgaard N, et al. Management of chronic venous disorders of the lower limbs. Guidelines according to scientific evidence. part I. Int Angiol. 2018;37:181–254. doi:10.23736/S0392-9590.18.03999-8
  • Rabe E, Guex -J-J, Morrison N, et al. Treatment of chronic venous disease with flavonoids: recommendations for treatment and further studies. Phlebology. 2013;28:308–319. doi:10.1177/0268355512471929
  • Garner RC, Garner JV, Gregory S, et al. Comparison of the absorption of micronized (Daflon 500 mg) and nonmicronized 14C-diosmin tablets after oral administration to healthy volunteers by accelerator mass spectrometry and liquid scintillation counting. J Pharm Sci. 2002;91:32–40. doi:10.1002/jps.1168
  • Kakkos SK, Nicolaides AN. Efficacy of micronized purified flavonoid fraction (Daflon®) on improving individual symptoms, signs and quality of life in patients with chronic venous disease: a systematic review and meta-analysis of randomized double-blind placebo-controlled trials. Int Angiol. 2018;37:143–154. doi:10.23736/S0392-9590.18.03975-5
  • Ramelet AA, Boisseau MR, Allegra C, et al. Veno-active drugs in the management of chronic venous disease. An international consensus statement: current medical position, prospective views and final resolution. Clin Hemorheol Microcirc. 2005;33:309–319.
  • Allaert FA. Meta-analysis of the impact of the principal venoactive drugs agents on malleolar venous edema. Int Angiol. 2012;31:310–315.
  • Henriet J. Insuffisance veineuse fonctionnelle: essai clinique comparatif d’une seule prise par jour de Diovenor 600 mg (600 mg de diosmine d’hémisynthèse) versus 2 prises par jour d’un mélange de 500 mg de flavonoïdes (900 mg de diosmine). [Functional venous insufficiency: comparative clinical trial of a single daily dose of DIOVENOR 600 mg (600 mg of hemisynthetic diosmin) versus two daily doses of a combination of 500 mg of flavonoids (900 mg of diosmin)]. Phlébologie (Annales Vasculaires). 1995;48:285–290.
  • Maruszynski A. A double blind, randomized study evaluating the influence of semisynthetic diosmin, and purified, micronized flavonoid fraction (diosmin and hesperidin), on symptoms of chronic venous insufficiency of lower limb - a four week observation. Przeglad Flebologiczny. 2004;13:89–95.
  • Steinbruch M, Nunes C, Gama R, et al. Is nonmicronized diosmin 600 mg as effective as micronized diosmin 900 mg plus hesperidin 100 mg on chronic venous disease symptoms? Results of a noninferiority study. Int J Vasc Med. 2020;2020:4237204.
  • Delecluse M, Ducros JJ, Egal G, et al. Essai clinique pragmatique de Diovenor 300 mg versus mélange de flavonoïdes à 90 % de diosmine dans le traitement des manifestations d’insuffisance veineuse chronique chez la femme active jeune. [Pragmatic clinical trial of Diovenor 300 mg versus a mixture of flavonoids with 90% diosmin in the treatment of symptoms of chronic venous insufficiency in young active women]. Artères et Veines. 1991;10:498–503.
  • Cospite M, Dominici A. Double blind study of the pharmacodynamic and clinical activities of 5682 SE in venous insufficiency. Advantages of the new micronized form. Int Angiol. 1989;8:61–65.
  • Martinez-Zapata MJ, Vernooij RWM, Uriona Tuma SM, et al. Phlebotonics for venous insufficiency. Cochrane Database Syst Rev. 2016;4:CD003229.
  • Eklöf B, Rutherford RB, Bergan JJ, et al. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg. 2004;40:1248–1252. doi:10.1016/j.jvs.2004.09.027
  • Martinez-Zapata MJ, Vernooij RWM, Simancas-Racines D, et al. Phlebotonics for venous insufficiency. Cochrane Database Syst Rev. 2020;3. doi:10.1002/14651858.CD003229.pub4
  • Nicolaides AN, Allegra C, Bergan J, et al. Management of chronic venous disorders of the lower limbs: guidelines according to scientific evidence. Int Angiol. 2008;27:1–59.
  • Perrin M, Ramelet AA. Pharmacological treatment of primary chronic venous disease: rationale, results and unanswered questions. Eur J Vasc Endovasc Surg. 2011;41:117–125. doi:10.1016/j.ejvs.2010.09.025
  • Nicolaides A, Kakkos S, Eklof B, et al. Management of chronic venous disorders of the lower limbs - guidelines according to scientific evidence. Int Angiol. 2014;33:87–208.
  • Martinez-Zapata MJ, Bonfill X, Moreno RM, Vargas E, Capellà D. Phlebotonics for venous insufficiency. Cochrane Database Syst Rev. 2005;3:CD003229. doi:10.1002/14651858.CD003229.pub2
  • Boudet C, Peyrin L. Comparative effect of tropolone and diosmin on venous COMT and sympathetic activity in rat. Arch Int Pharmacodyn Ther. 1986;283:312–320.
  • Savineau JP, Marthan R. Diosmin-induced increase in sensitivity to Ca2+ of the smooth muscle contractile apparatus in the rat isolated femoral vein. Br J Pharmacol. 1994;111:978–980. doi:10.1111/j.1476-5381.1994.tb14838.x
  • Bodinier M, Ly S, Finet M, Jean T. Etude in vitro de l’effet anti-inflammatoire de la diosmine d’hémisynthèse° dans un système de co-culture de cellules endothéliales veineuses et de granulocytes humains. [In vitro study of the anti-inflammatory effect of hemisynthetic diosmin in a co-culture system of human venous endothelial cells and  granulocytes]. Artères et Veines. 1994;XIII:124–128.
  • Bogachev VY, Boldin BV, Lobanov VN. Benefits of micronized purified flavonoid fraction as adjuvant therapy on inflammatory response after sclerotherapy. Int Angiol. 2018;37:71–78. doi:10.23736/S0392-9590.17.03868-8
  • Rabe E, Agus GB, Roztocil K. Analysis of the effects of micronized purified flavonoid fraction versus placebo on symptoms and quality of life in patients suffering from chronic venous disease: from a prospective randomized trial. Int Angiol. 2015;34:428–436.
  • Danielsson G, Jungbeck C, Peterson K, Norgren L. A randomised controlled trial of micronised purified flavonoid fraction vs placebo in patients with chronic venous disease. Eur J Vasc Endovasc Surg. 2002;23:73–76. doi:10.1053/ejvs.2001.1531
  • Carpentier PH, Mathieu M. Evaluation de l’efficacité clinique d’un médicament veinotrope: les enseignements d’un essai thérapetique avec la diosmine d’hémisynthèse dans le syndrome des jambes lourdes. [Assessment of the clinical effectiveness of a venotropic drug: findings from a therapeutic trial with hemisynthetic diosmin in heavy legs syndrome]. J des Maladies Vasculaires (Paris). 1998;23:106–112.
  • Cazaubon M, Bailly C, Ducros E, Lancrenon S. Étude comparative d’acceptabilité, d’efficacité et de tolérance de deux formes galéniques de diosmine 600 mg, dans le traitement des symptômes de la maladie veineuse chronique. [Acceptability, efficacy and safety of two pharmaceutical forms of diosmin 600 mg in patients with chronic venous disease: a  comparative study]. Angéiologie. 2011;63:69.