Benzo-pyrones for reducing and controlling lymphoedema of the limbs.
Identifieur interne : 003B76 ( PubMed/Checkpoint ); précédent : 003B75; suivant : 003B77Benzo-pyrones for reducing and controlling lymphoedema of the limbs.
Auteurs : C. Badger ; N. Preston ; K. Seers ; Peter Mortimer (dermatologue) [Royaume-Uni]Source :
- The Cochrane database of systematic reviews [ 1469-493X ] ; 2004.
Descripteurs français
- KwdFr :
- Anticoagulants (usage thérapeutique), Benzopyranes (usage thérapeutique), Coumarines (usage thérapeutique), Diosmine (usage thérapeutique), Essais contrôlés randomisés comme sujet, Extraits de plantes (usage thérapeutique), Humains, Lymphoedème (traitement médicamenteux), Membres, O-(bêta-Hydroxyéthyl)rutosides (analogues et dérivés), O-(bêta-Hydroxyéthyl)rutosides (usage thérapeutique).
- MESH :
- analogues et dérivés : O-(bêta-Hydroxyéthyl)rutosides.
- traitement médicamenteux : Lymphoedème.
- usage thérapeutique : Anticoagulants, Benzopyranes, Coumarines, Diosmine, Extraits de plantes, O-(bêta-Hydroxyéthyl)rutosides.
- Essais contrôlés randomisés comme sujet, Humains, Membres.
English descriptors
- KwdEn :
- Anticoagulants (therapeutic use), Benzopyrans (therapeutic use), Coumarins (therapeutic use), Diosmin (therapeutic use), Extremities, Humans, Hydroxyethylrutoside (analogs & derivatives), Hydroxyethylrutoside (therapeutic use), Lymphedema (drug therapy), Plant Extracts (therapeutic use), Randomized Controlled Trials as Topic.
- MESH :
- chemical , analogs & derivatives : Hydroxyethylrutoside.
- chemical , therapeutic use : Anticoagulants, Benzopyrans, Coumarins, Diosmin, Hydroxyethylrutoside, Plant Extracts.
- drug therapy : Lymphedema.
- Extremities, Humans, Randomized Controlled Trials as Topic.
Abstract
Lymphoedema is the accumulation of excess fluid in the body caused by obstruction of the lymphatic drainage mechanisms. It can be caused by a number of factors, including congenital predisposition, parasitic infection or surgery. Lymphoedema is chronic and progressive and affects a significant proportion of the population. The standard treatment regimes include compression hosiery, skin care and exercise. The use of drugs in treatment, particularly benzo-pyrones, has gained favour over the last ten years. Benzo-pyrones, originally developed for use in vascular medicine, are prescribed to reduce vascular permeability and thus the amount of fluid forming in the subcutaneous tissues. Advocates for this treatment method believe that, as a result of reducing filtration, the drugs have some beneficial effect on pain and discomfort in the swollen areas. Proponents also claim that these drugs increase macrophage activity, encouraging the lysis of protein, which in turn reduces the formation of fibrotic tissue in the lymphoedematous limb.
DOI: 10.1002/14651858.CD003140.pub2
PubMed: 15106192
Affiliations:
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Seers</name></author><author><name sortKey="Mortimer, P" sort="Mortimer, P" uniqKey="Mortimer P" first="P" last="Mortimer">Peter Mortimer (dermatologue)</name><affiliation><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName type="university">Université de Londres</orgName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2004">2004</date><idno type="RBID">pubmed:15106192</idno><idno type="pmid">15106192</idno><idno type="doi">10.1002/14651858.CD003140.pub2</idno><idno type="wicri:Area/PubMed/Corpus">004017</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">004017</idno><idno type="wicri:Area/PubMed/Curation">004017</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">004017</idno><idno type="wicri:Area/PubMed/Checkpoint">004017</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">004017</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Benzo-pyrones for reducing and controlling lymphoedema of the limbs.</title><author><name sortKey="Badger, C" sort="Badger, C" uniqKey="Badger C" first="C" last="Badger">C. Badger</name></author><author><name sortKey="Preston, N" sort="Preston, N" uniqKey="Preston N" first="N" last="Preston">N. Preston</name></author><author><name sortKey="Seers, K" sort="Seers, K" uniqKey="Seers K" first="K" last="Seers">K. Seers</name></author><author><name sortKey="Mortimer, P" sort="Mortimer, P" uniqKey="Mortimer P" first="P" last="Mortimer">Peter Mortimer (dermatologue)</name><affiliation><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName type="university">Université de Londres</orgName></affiliation></author></analytic><series><title level="j">The Cochrane database of systematic reviews</title><idno type="eISSN">1469-493X</idno><imprint><date when="2004" type="published">2004</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anticoagulants (therapeutic use)</term><term>Benzopyrans (therapeutic use)</term><term>Coumarins (therapeutic use)</term><term>Diosmin (therapeutic use)</term><term>Extremities</term><term>Humans</term><term>Hydroxyethylrutoside (analogs & derivatives)</term><term>Hydroxyethylrutoside (therapeutic use)</term><term>Lymphedema (drug therapy)</term><term>Plant Extracts (therapeutic use)</term><term>Randomized Controlled Trials as Topic</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Anticoagulants (usage thérapeutique)</term><term>Benzopyranes (usage thérapeutique)</term><term>Coumarines (usage thérapeutique)</term><term>Diosmine (usage thérapeutique)</term><term>Essais contrôlés randomisés comme sujet</term><term>Extraits de plantes (usage thérapeutique)</term><term>Humains</term><term>Lymphoedème (traitement médicamenteux)</term><term>Membres</term><term>O-(bêta-Hydroxyéthyl)rutosides (analogues et dérivés)</term><term>O-(bêta-Hydroxyéthyl)rutosides (usage thérapeutique)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="analogs & derivatives" xml:lang="en"><term>Hydroxyethylrutoside</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anticoagulants</term><term>Benzopyrans</term><term>Coumarins</term><term>Diosmin</term><term>Hydroxyethylrutoside</term><term>Plant Extracts</term></keywords><keywords scheme="MESH" qualifier="analogues et dérivés" xml:lang="fr"><term>O-(bêta-Hydroxyéthyl)rutosides</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Anticoagulants</term><term>Benzopyranes</term><term>Coumarines</term><term>Diosmine</term><term>Extraits de plantes</term><term>O-(bêta-Hydroxyéthyl)rutosides</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Extremities</term><term>Humans</term><term>Randomized Controlled Trials as Topic</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Essais contrôlés randomisés comme sujet</term><term>Humains</term><term>Membres</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Lymphoedema is the accumulation of excess fluid in the body caused by obstruction of the lymphatic drainage mechanisms. It can be caused by a number of factors, including congenital predisposition, parasitic infection or surgery. Lymphoedema is chronic and progressive and affects a significant proportion of the population. The standard treatment regimes include compression hosiery, skin care and exercise. The use of drugs in treatment, particularly benzo-pyrones, has gained favour over the last ten years. Benzo-pyrones, originally developed for use in vascular medicine, are prescribed to reduce vascular permeability and thus the amount of fluid forming in the subcutaneous tissues. Advocates for this treatment method believe that, as a result of reducing filtration, the drugs have some beneficial effect on pain and discomfort in the swollen areas. Proponents also claim that these drugs increase macrophage activity, encouraging the lysis of protein, which in turn reduces the formation of fibrotic tissue in the lymphoedematous limb.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">15106192</PMID><DateCreated><Year>2004</Year><Month>04</Month><Day>23</Day></DateCreated><DateCompleted><Year>2004</Year><Month>08</Month><Day>17</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1469-493X</ISSN><JournalIssue CitedMedium="Internet"><Issue>2</Issue><PubDate><Year>2004</Year></PubDate></JournalIssue><Title>The Cochrane database of systematic reviews</Title><ISOAbbreviation>Cochrane Database Syst Rev</ISOAbbreviation></Journal><ArticleTitle>Benzo-pyrones for reducing and controlling lymphoedema of the limbs.</ArticleTitle><Pagination><MedlinePgn>CD003140</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Lymphoedema is the accumulation of excess fluid in the body caused by obstruction of the lymphatic drainage mechanisms. It can be caused by a number of factors, including congenital predisposition, parasitic infection or surgery. Lymphoedema is chronic and progressive and affects a significant proportion of the population. The standard treatment regimes include compression hosiery, skin care and exercise. The use of drugs in treatment, particularly benzo-pyrones, has gained favour over the last ten years. Benzo-pyrones, originally developed for use in vascular medicine, are prescribed to reduce vascular permeability and thus the amount of fluid forming in the subcutaneous tissues. Advocates for this treatment method believe that, as a result of reducing filtration, the drugs have some beneficial effect on pain and discomfort in the swollen areas. Proponents also claim that these drugs increase macrophage activity, encouraging the lysis of protein, which in turn reduces the formation of fibrotic tissue in the lymphoedematous limb.</AbstractText><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">To assess the effectiveness of benzo-pyrones compared to placebo or to different benzo-pyrones in reducing limb volume, pain and discomfort in lymphoedematous limbs. To assess the effect of benzo-pyrones on the quality of affected tissues and on the patient's quality of life and, finally, to establish the incidence of adverse effects</AbstractText><AbstractText Label="SEARCH STRATEGY" NlmCategory="METHODS">We searched the Cochrane Breast Cancer Group register (September 2003), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 4,2003), MEDLINE, EMBASE, CINAHL, UnCover, PASCAL, SIGLE, reference lists produced by The British Lymphology Society, the National Research Register (NRR) and The International Society of Lymphology congress proceedings.</AbstractText><AbstractText Label="SELECTION CRITERIA" NlmCategory="METHODS">Types of studies considered for review were randomised controlled trials testing Paroven, coumarin, Venastat, Cyclo 3 Fort or Daflon versus placebo (with both groups having or not having standard physical treatment</AbstractText><AbstractText Label="DATA COLLECTION AND ANALYSIS" NlmCategory="METHODS">Eligibility for inclusion was confirmed by two blinded reviewers who screened the papers independently using a checklist of criteria relating to the randomisation and blinding of the trial. Both reviewers extracted data from the eligible studies using a data extraction form.</AbstractText><AbstractText Label="MAIN RESULTS" NlmCategory="RESULTS">Overall, 15 trials were included that evaluated the role of benzo-pyrones. Three trials of oxerutin were found. Each tested the drug over 6 months using the same dose of drug against placebo. Two were crossover trials and one a parallel group trial with a total number of 127 participants and data available for only 81 of them. There were insufficient data provided in any of the trials to calculate the per cent reduction or increase in baseline excess limb volume. Standard deviations or confidence intervals and the numbers in the groups at the different stages of the trial were missing for all the data in two of the reports and for much of the data in the third, making any attempt at meta-analysis impossible. One trial testing Cyclo 3 Fort (approved name) over 3 months was found and involved 57 patients but provided insufficient data to allow a proper analysis of its findings. A single trial of Daflon (approved name) was found, lasting 6 months and involving 104 participants; once again there was insufficient information provided in the report to reach a conclusion about the effectiveness of the drug. Three trials of coumarin combined with troxerutin were found and tested two different doses of the drug against each other with no placebo, however, numbers of participants in the trial groups and baseline data were not provided. Eight trials of coumarin were identified. Two of the reports were confirmed as reporting the same trial and a further trial potentially also referred to the same trial but this was unconfirmed. A further two papers appeared to refer to the same trial but this was not confirmed. Three trials involved the same researcher. Five studies were conducted in India or China and they added anti-filarial dia or China and they added anti-filarial drugs to the interventions tested. The numbers of participants withdrawn and the numbers included in the analyses in all these trials were not extractable; the reporting of outcome measures in most of the trials was not clear. Loprinzi's 1999 trial in the USA reported the conduct of the trial and its findings with more detail, however, its conclusions were very much at odds with the findings of the other trials, finding that no difference was observed between those on the active preparation (coumarin) and placebo in any of the outcomes under investigation. This trial also reported a case of hepato-toxicity in a patient receiving the active preparation.</AbstractText><AbstractText Label="REVIEWERS' CONCLUSIONS" NlmCategory="CONCLUSIONS">Meta-analysis was not performed due to the poor quality of the trials. It is not possible to draw conclusions about the effectiveness of Benzopyrones in reducing limb volume, pain, or discomfort in lymphoedematous limbs from these trials.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Badger</LastName><ForeName>C</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Preston</LastName><ForeName>N</ForeName><Initials>N</Initials></Author><Author ValidYN="Y"><LastName>Seers</LastName><ForeName>K</ForeName><Initials>K</Initials></Author><Author ValidYN="Y"><LastName>Mortimer</LastName><ForeName>P</ForeName><Initials>P</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Cochrane Database Syst Rev</MedlineTA><NlmUniqueID>100909747</NlmUniqueID><ISSNLinking>1361-6137</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000925">Anticoagulants</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D001578">Benzopyrans</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D003374">Coumarins</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D006896">Hydroxyethylrutoside</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D010936">Plant Extracts</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="C013343">cyclo 3</NameOfSubstance></Chemical><Chemical><RegistryNumber>7QM776WJ5N</RegistryNumber><NameOfSubstance UI="D004145">Diosmin</NameOfSubstance></Chemical><Chemical><RegistryNumber>7Y4N11PXO8</RegistryNumber><NameOfSubstance UI="C005865">troxerutin</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000925" MajorTopicYN="N">Anticoagulants</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001578" MajorTopicYN="N">Benzopyrans</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003374" MajorTopicYN="N">Coumarins</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004145" MajorTopicYN="N">Diosmin</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005121" MajorTopicYN="N">Extremities</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006896" MajorTopicYN="N">Hydroxyethylrutoside</DescriptorName><QualifierName UI="Q000031" MajorTopicYN="N">analogs & derivatives</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010936" MajorTopicYN="N">Plant Extracts</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016032" MajorTopicYN="N">Randomized Controlled Trials as Topic</DescriptorName></MeshHeading></MeshHeadingList><NumberOfReferences>80</NumberOfReferences></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2004</Year><Month>4</Month><Day>24</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2004</Year><Month>8</Month><Day>18</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2004</Year><Month>4</Month><Day>24</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">15106192</ArticleId><ArticleId IdType="doi">10.1002/14651858.CD003140.pub2</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement><orgName><li>Université de Londres</li></orgName></list><tree><noCountry><name sortKey="Badger, C" sort="Badger, C" uniqKey="Badger C" first="C" last="Badger">C. Badger</name><name sortKey="Preston, N" sort="Preston, N" uniqKey="Preston N" first="N" last="Preston">N. Preston</name><name sortKey="Seers, K" sort="Seers, K" uniqKey="Seers K" first="K" last="Seers">K. Seers</name></noCountry><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Mortimer, P" sort="Mortimer, P" uniqKey="Mortimer P" first="P" last="Mortimer">Peter Mortimer (dermatologue)</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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