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Sulodexide for venous stasis ulcers

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    Sulodexide, a highly purified glycosaminoglycan (a naturally occurring molecule) has antithrombotic and profibrinolytic properties (it reduces the formation of blood clots) as well as anti-inflammatory effects. Sulodexide has been studied as a potential treatment for venous leg ulcers.

    Wu B and colleagues investigated four randomized controlled trials (RCT) with a total of 463 participants (aged 42 years to 93 years); one report was only available as a published abstract. Meta-analysis of three RCTs suggests an increase in the proportion of ulcers completely healed with sulodexide as an adjuvant to local treatment (including wound care and compression therapy) compared with local treatment alone.  The rate of complete healing with sulodexide was found to be 49.4% compared with 29.8% with local treatment alone; RR 1.66; 95% confidence interval (CI).

    Wu and colleagues concluded that "Sulodexide may increase the healing of venous ulcers, when used with local wound care, however the evidence is only low quality and the conclusion is likely to be affected by new research. It is not clear whether sulodexide is associated with adverse effects. The standard dosage, route and frequency of sulodexide reported in the trials was unclear. Further rigorous, adequately powered RCTs examining the effects of sulodexide on healing, ulcer recurrence, quality of life and costs are necessary".

    Sulodexide is a highly purified mixture of glycosaminoglycans composed of low molecular weight heparin (80%) and dermatan sulfat 920%). 

    Wu B, Lu J, Yang M and Xu T. Sulodexide for treating venous leg ulcers. Cochrane Database System Review 2016; 6: CDO10694.

    Dr Karamanoukian's note:  Sulodexide is not FDA approved for use in the United States and is not available for sale in the United States.  Sulodexide has not been studied in children.