Pentoxifylline effective for venous leg ulcers and simvastatin may also work

Goodfellow Gems Logo

Goodfellow Gems

"Pentoxifylline effective for venous leg ulcers and simvastatin may also work"

A Cochrane review of pentoxifylline (Trental) 400mg TDS, with and without compression, found it to be effective for healing or significantly improving venous leg ulcers.1 This is based on 11 randomised trials and the numbers needed to treat were 5. This is an option for those who do not tolerate compression and is good quality evidence. The second study randomised 66 patients to 40 mg of simvastatin or placebo. The authors report that over 50% of leg ulcers completely healed at 10 weeks.2
This study has been criticised as being too good to be true with a large effect size in a small study.3 There are larger trials being conducted but results are not available. Simvastatin may be an option when all else had failed for this sometimes difficult to treat condition as it is a relatively safe medication.

References:

  1. Jull AB, et al  Pentoxifylline for treating venous leg ulcers. Cochrane Database of Systematic Reviews 2012, Issue 12. Art. No.: CD001733. DOI: 10.1002/14651858.CD001733.pub3.
  2. M.T.P. Evangelis et al . Simvastatin as a novel therapeutic agent for venous ulcers: a randomized, double-blind, placebo-controlled trial. http://onlinelibrary.wiley.com/doi/10.1111/bjd.12883/epdf
  3. Dickerson JD et al. Br J Dermatol. 2015 Apr; 172(4): 1132–1133. Published online 2015 Mar 11. doi:  10.1111/bjd.13349

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.


As published in NZ Doctor 19/08/2015