Efficacy of the treatment with prostaglandin E-1 in venous ulcers of the lower limbs

J Vasc Surg. 2005 Aug;42(2):304-8. doi: 10.1016/j.jvs.2005.03.040.

Abstract

Background: Venous ulcers represent an important medical problem because of their high prevalence and consequent sanitary costs. In this study, we evaluated the effect of prostaglandin E-1 (PGE-1), a drug that improves district ischemia, on the healing of venous ulcers.

Methods: We performed a randomized, placebo-controlled, single blind study in which 87 patients who had venous leg ulcers homogeneous for dimensions and characteristics were treated for 20 days with an infusion of prostaglandin E-1 or placebo, in association with topical therapy. The dimension and the number of the ulcers were determined at the beginning of the treatment and then every 20 days up to 4 months, or until total recovery. The main outcome of the study was the recovery percentage of the ulcers at the end of the 120-day period of observation and the referred healing time. The reduction in the extension of ulcers from the baseline measurement to the last observation was also evaluated.

Results: The baseline characteristics of the treatment and control groups were similar. The reduction in the size of the ulcers was faster in the patients treated with PGE-1. In this group, 100% of the ulcers healed < or = 100 days, whereas in the placebo group, only 84.2% did so by the end of the 120-day observation period (P < .05). The estimated healing times of 25%, 50%, and 75% of the patients treated with PGE-1 were 23, 49, and 72 days, respectively, compared with 52, 80, and 108 for the patients in the placebo group. Only one serious event occurred in the treated group.

Conclusions: This study demonstrates the effectiveness of PGE-1 in reducing the healing time of venous ulcers, suggesting that venous ulcers should also be considered ischemic.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alprostadil / pharmacology
  • Alprostadil / therapeutic use*
  • Female
  • Humans
  • Leg / blood supply*
  • Male
  • Middle Aged
  • Single-Blind Method
  • Ultrasonography, Doppler, Duplex
  • Varicose Ulcer / diagnostic imaging
  • Varicose Ulcer / drug therapy*
  • Varicose Ulcer / physiopathology
  • Vasodilator Agents / pharmacology
  • Vasodilator Agents / therapeutic use*
  • Wound Healing / drug effects

Substances

  • Vasodilator Agents
  • Alprostadil