Systemic treatment of venous leg ulcers with high doses of pentoxifylline: efficacy in a randomized, placebo-controlled trial

被引:73
作者
Falanga, V
Fujitani, RM
Diaz, C
Hunter, G
Jorizzo, J
Lawrence, PF
Lee, BY
Menzoian, JO
Tretbar, LL
Holloway, GA
Hoballah, J
Seabrook, GR
McMillan, DE
Wolf, W
机构
[1] Boston Univ, Boston, MA 02215 USA
[2] Wilford Hall USAF Med Ctr, Lackland AFB, TX 78236 USA
[3] Brooklyn VA Med Ctr, Brooklyn, NY USA
[4] Vet Adm Med Ctr, Tucson, AZ 85723 USA
[5] Bowman Grey Med Ctr, Winston Salem, NC USA
[6] Univ Utah, Salt Lake City, UT USA
[7] Vet Adm Med Ctr, Castle Point, NY USA
[8] Univ Missouri, Kansas City, MO 64110 USA
[9] Maricopa Med Ctr, Phoenix, AZ USA
[10] Univ Iowa, Iowa City, IA USA
[11] Milwaukee Cty Hosp, Milwaukee, WI USA
[12] Arizona Med Clin, Peoria, IL USA
[13] Univ Florida, Tampa, FL USA
关键词
D O I
10.1046/j.1524-475X.1999.00208.x
中图分类号
Q2 [细胞生物学];
学科分类号
071009 ; 090102 ;
摘要
Several small studies have indicated that the systemic administration of pentoxifylline may accelerate healing of venous leg ulcers. The goal of this study was to further evaluate these findings in a larger scale placebo controlled trial and to explore the effect of the dose of pentoxifylline on healing. The study used a prospective, randomized, double-blind, parallel group placebo controlled design in a multicenter outpatient setting. Patients with one or more venous ulcer were enrolled, with all patients receiving standardized compression bandaging for treatment for their ulcers. Patients were also randomized to receive either pentoxifylline 400 mg, pentoxifylline 800 mg (two 400 mg tablets), or placebo tablets three times a day for up to 24 weeks. The main outcome measure was time to complete healing of all leg ulcers, using life table analysis. The study was completed as planned in 131 patients. Patients receiving 800 mg three times a day of pentoxifylline healed faster than placebo (p = 0.043, Wilcoxon test). The median time to complete healing was 100, 83, and 71 days for placebo, pentoxifylline 400 mg, and pentoxifylline 800 mg three times a day, respectively. Over half of all patients were ulcer free at week 16 (placebo) and at week 12 in both pentoxifylline groups. Whereas the placebo group had only achieved complete healing in half of the cases by week 16, all of the subjects remaining in the group receiving the high dose of pentoxifylline had healed completely. Treatment with pentoxifylline was well tolerated with similar drop-out rates in all three treatment groups. Complete wound closure occurred at least 4 weeks earlier in the majority of patients treated with pentoxifylline by comparison to placebo, A higher dose of pentoxifylline (800 mg three times a day) was more effective than the lower dose. We conclude that pentoxifylline is effective in accelerating healing of leg ulcers.
引用
收藏
页码:208 / 213
页数:6
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