Pentoxifylline for treating venous leg ulcers.

Jull AB, Arroll B, Parag V, Waters J

Published Online:

January 19, 2011

Venous leg ulcers are a common, recurring and disabling condition. The mainstay of treatment is the use of firm compression bandages or stockings to support the veins of the leg. Some leg ulcers take many months or years to heal and treatment is aimed at preventing infection and speeding up healing. Pentoxifylline is a tablet taken to improve blood circulation. The review of trials suggests that pentoxifylline, 400 mg tablet taken three times a day, increases the chance of healing.

Abstract (click to read)

Background:

Healing of venous leg ulcers is improved by the use of compression bandaging but some venous ulcers remain unhealed, and some people are unsuitable for compression therapy. Pentoxifylline, a drug which helps blood flow, has been used to treat venous leg ulcers.

Objectives:

To assess the effects of pentoxifylline (oxpentifylline or Trental 400) for treating venous leg ulcers, compared with a placebo or other therapies, in the presence or absence of compression therapy.

Search strategy:

For this third update we searched the Cochrane Wounds Group Specialised Register (searched 19 November 2010); The Cochrane Central Register of Controlled Trials (CENTRAL) - The Cochrane Library 2010 Issue 4; Ovid MEDLINE (2009 to November Week 1 2010); Ovid MEDLINE In-Process & Other Non-Indexed Citations (November 18, 2010); Ovid EMBASE (2009 to 2010 Week 45); EBSCO CINAHL (2009 to 19 November 2010) and checked reference lists of relevant articles.

Selection criteria:

Randomised trials comparing pentoxifylline with placebo or other therapy in the presence or absence of compression, in people with venous leg ulcers.

Data collection and analysis:

One review author extracted and summarised details from eligible trials using a coding sheet. One other review author independently verified data extraction.

Main results:

No new trials were identified for this update. We included twelve trials involving 864 participants. The quality of trials was variable. Eleven trials compared pentoxifylline with placebo or no treatment. Pentoxifylline is more effective than placebo in terms of complete ulcer healing or significant improvement (RR 1.70, 95% CI 1.30 to 2.24). Pentoxifylline plus compression is more effective than placebo plus compression (RR 1.56, 95% CI 1.14 to 2.13). Pentoxifylline in the absence of compression appears to be more effective than placebo or no treatment (RR 2.25, 95% CI 1.49 to 3.39).

More adverse effects were reported in people receiving pentoxifylline (RR 1.56, 95% CI 1.10 to 2.22). Nearly three-quarters (72%) of the reported adverse effects were gastrointestinal.

Authors' conclusions:

Pentoxifylline is an effective adjunct to compression bandaging for treating venous ulcers and may be effective in the absence of compression. The majority of adverse effects were gastrointestinal disturbances.

This record should be cited as:

Jull AB, Arroll B, Parag V, Waters J. Pentoxifylline for treating venous leg ulcers. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD001733. DOI: 10.1002/14651858.CD001733.pub2

Assessed as up to date:

November 22, 2010

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Primary Review Group:

Wounds Group

Health topics:

Heart & circulation > Ulcers: venous > Systemic drug therapy

Wounds > Ulcers: venous > Systemic drug therapy

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Pentoxifylline for treating venous leg ulcers.

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