Micronized Purified Flavonoid Fraction (MPFF) for Patients Suffering from Chronic Venous Disease: A Review of New Evidence

Abstract

Chronic venous disease (CVD) is both prevalent and unavoidable in many people as a result of persistent or unalterable risk factors, the most important of which are advanced age, excess body weight, and family history. Given this inevitability, medical treatment is required to alleviate symptoms and slow disease progression. Venoactive drug therapy is emerging as a valuable treatment option for many CVD patients and micronized purified flavonoid fraction (MPFF) is the most widely prescribed and well-studied venoactive drug available. Recent evidence from animal models of venous hypertension and from clinical trials, as well as from systematic reviews, shows that MPFF is effective at alleviating many of the most common symptoms of CVD including leg pain, leg heaviness, sensations of swelling, cramps, and functional discomfort. In addition, MPFF improves the clinical signs of redness, skin changes, and edema, and improves quality of life. Collectively, these findings support the strong recommendation for MPFF treatment found in the 2018 international guidelines for the management of CVD.Funding: Servier.

Keywords: Cardiology; Chronic venous disease; Chronic venous insufficiency; Flavonoid; Inflammation; MPFF; Micronized purified flavonoid fraction; Venoactive drugs; Venous hypertension.

Fig. 1

Schematic representation of ligature models. A Right femoral vein above the origin of superficial epigastric vein; B origin of right branch of femoral vein; C origin of left branch of femoral vein; and D upper third of right external iliac vein. Reproduced with permission from das Graças C de Souza M, Cyrino F, de Carvalho J. et al. Protective Effects of Micronized Purified Flavonoid Fraction (MPFF) on a Novel Experimental Model of Chronic Venous Hypertension. Eur J Vasc Endovasc Surg. 2018;55:694–702 [10]

Fig. 2

Lower limb discomfort progressively and significantly improves in patients with C0s–C4 CVD. Patients were treated with 1000 mg MPFF suspension × 1/day or 500 mg tablet × 2/day for 8 weeks. Leg discomfort was assessed weekly by visual analog scale. Reprinted by permission of Edizioni Minerva Medica from: International Angiology 2017 October;36(5):402–9 [13]